Management Of First Stage Labor Discussion

Management Of First Stage Labor Discussion

There are three phases of labor, the first of which is when the uterus contracts and then relaxes. The baby is born at the conclusion of the second stage, which involves pushing. The placenta is delivered at this point.

The cervix is normally lengthy and hard prior to the onset of labor. The uterine muscles shorten and soften the cervix in preparation for dilation during the early hours of labor. During the first stage of labor and childbirth, a woman’s contractions become more and more regular and intense. They get increasingly intense, regular, and frequent as time goes on. Management Of First Stage Labor Discussion

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One of the female reproductive organs, sometimes known as the “womb,” is an 8-centimeter-long hollow muscle structure that rests dorsocranially on the bladder. It is important to note that the uterus is divided into four major sections: The fundus, which is a broad curved area where the fallopian tubes are attached; the body, which begins below the fallopian tubes and continues downward until it narrows; the uterine cavity, which is located between the fallopian tubes and the uterine walls. The cervix, isthmus, and body are all elements of the reproductive system. As the cervix descends from the isthmus, it reaches its lowest point, the vagina, where it meets the uterus. Its histology is more intricate than its anatomy suggests. When it is in the or proliferative phase, the histological structure of the three primary layers changes. This organ is also responsible for the development of the embryo and baby during pregnancy. Management Of First Stage Labor Discussion

The uterine lining receives the fertilized egg when you conceive throughout your monthly period. In the endometrium of your uterus, the fertilized egg makes its home.

The uterus expands and thins out like a balloon during pregnancy to make room for the growing fetus and the amniotic fluid that protects it, initially generated by the woman and subsequently by the baby’s urine and lung discharges.

Uterus muscles spasm intermittently throughout pregnancy as the uterus prepares for delivery. Menstrual pains may be mistaken for the “practice” Braxton-Hicks contractions, which some women don’t even detect. However, these contractions are not the more intense and regular ones that are capable of squeezing the fetus out of the uterus. Management Of First Stage Labor Discussion

As labor progresses, the cervix widens as a result of the contractions. This is the stage of labor that takes the longest on average. Early labor, active labor, and the transition period comprise the bulk of this stage. They help your baby enter the delivery canal by opening (dilating) and softening (effacing) the cervix. This period might last anywhere from six to 36 hours for first-time moms. The cervix begins to soften in preparation for opening as labor progresses. Unsettled contractions define this period, which is known as the latent phase. Once the labor is established, it might take several hours or even days.

During this period, contractions, a show, and the bursting of water are all possible. It is possible that some of the contractions might be fairly moderate, like a period discomfort, while others can be acute and intense. Labor is termed to be “established” when contractions are five minutes apart and last a minute or longer. A’show’ is the ejection of a thick and stringy or blood-tinged clump of mucus. A week or more before labor begins, you may experience this. “breaking of your waters,” it signifies the baby’s amniotic sac has burst.

Fundal Dominance

When the uterus is contracting, it is difficult to touch it. During the early stages of labor, the neurological system is in charge of regulating the contractions, which are both painless and unintentional. The fundus begins to compress around one of the cornua and expands outward and downward from there.

On the fundus, contractions persist longer and are more powerful. Management Of First Stage Labor Discussion

Polarity

 

When it comes to labor, the uterus’ two poles or segments are in sync with each other via neuromuscular harmony. The foetus is expelled from the uterus by a forceful contraction of the top pole. The foetus is able to exit via the lower pole, which dilates and contracts somewhat. When polarity is out of whack, the flow of work will be slowed.

3. Contraction & Retraction

Instead of entirely relaxing, the muscle fibers shorten. Helps the fetus to be expelled more gradually. During labor, the contractions do not go away altogether, but the muscular fibers shorten instead of relaxing totally (retraction)

4. Retraction ring

As the top section shrinks and retracts and the lower segment becomes thinner to accommodate the descending fetus, this physiological band progressively rises.

An imaginary ridge arises between the upper and lower uterine segments, which is known as the retraction ring. As long as it isn’t noticeable above the symphysis pubis, it’s entirely acceptable during childbirth.

The retraction ring stops rising after the cervix is sufficiently dilated and the fetus may exit the uterus. But this physiological retraction ring is seen above the pubis in severe situations of mechanically blocked labor and is called Bandl’s ring. Management Of First Stage Labor Discussion

Cervical effacement

The cervical canal is now a part of the lower uterine section, which was formerly separate. It may happen in the last stages of pregnancy, or it may be delayed until labor has begun. There is no cervical dilation until effacement is complete in nulliparous women. In contrast, effacement and dilatation may occur at the same time in pregnant women.

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. The Shortening and Dilation of The Cervix

A thick, rigid cone protrudes into the vagina of a primagravida before labor starts. At the very least, it is a half-inch long. When labor begins, the uterus’s thicker lower segment is drawn away from the presenting region while the uterus’s tightly contracted upper segment retracts and shortens. The lower leg muscles are strained as a result.

. Show

For the duration of pregnancy, a mucus plug called an operculum seals the cervical canal. This stops pathogens from entering the uterine cavity in conjunction with the intact membranes. Management Of First Stage Labor Discussion

History

Name, age, sex, marital status, domicile, education level, profession, and address are all examples of demographic data.

Medical history: Prior admissions, blood transfusion, surgery, chronic disease, food/drug allergies, and other medical conditions.

Present medical history: Any concurrent condition, is she on any medication.

The history of gynaecology the menstrual cycle, menopause, menopause symptoms, menopause symptoms inquire about the possibility of sexually transmitted infections (STIs)

A chronology of family planning methods employed and when they were discontinued

When it comes to the patient and her husband’s marital status and other personal details, social economic history is an important part of a patient’s care.

A/D, cause of death if any, and any history of a chronic illness running through the woman’s lineage are all part of her family’s medical history.

a thorough check from head to toe to rule out any anomalies.

If necessary, do a vaginal exam: Management Of First Stage Labor Discussion

Assess

External genitalia rule out warts, oedema, sores, and varicose veins. ‘

whether it’s wet or dry, the vagina is in a state of warmth and moisture.

Consistency and dilation of the cervix are important.

Confirming the presentation and positioning of the component eliminates caput and molding.

Identify the location of the section that will be presented

Determine whether or whether the membranes have been ruptured, and if so, whether or not the cord has been prolapsed or presented.

Assess the adequacy of the pelvis

Educate the mother about her own health:

To drink a lot of liquid orally

It is possible to induce labor with a warm birth.

Encourage her to get up and walk about to speed up the delivery process and boost descent.

During a contraction, provide sacral massage to ease back discomfort.

To avoid obstruction of the inferior venacava and early pressing, it is best to lay on the left side.

Prevent fetal hypoxia by teaching her breathing exercises.

Avoid early pushing since it may cause vulva oedema.

Explain to her what is expected during 2nd stage of labour Management Of First Stage Labor Discussion

Emotional support

This is done through instilling confidence, displaying care and reliability, and advocating for the mother.

Because of this, a non-judgmental approach from the midwife is essential, no matter what the woman’s response is to childbirth may be.

In the workplace, a companion: Having a friend or family member at her side might ease her worry, keep her company, and even assist her get about if she’s ambulant.

Conveying and Disseminating Knowledge

Information given by midwives must guarantee the woman knows what is happening, is able to ask questions about it, and can keep track of the progress of labor.

Before beginning any operation, make sure you get the patient’s verbal agreement and go through the specifics of what will be done.

Midwives are trained to provide positive encouragement and feedback to their patients after an operation.

3 Vaccination and Antibiotic Use

Maintaining good hygiene is essential.

Encourage women who are experiencing a normal labor to labor as close to home as feasible in order to cut down on the amount of time they spend at the hospital. Management Of First Stage Labor Discussion

Minimize the use of invasive procedures.

Vaginal exams should be kept to a minimum.

Pre-labor rupture of the fetus’ membranes occurs when the pregnancy is full term.

Within 24 hours, the vast majority of women with PROM will give birth.

Digital inspection should be avoided after PROM if there are no symptoms of labor or apparent liquid emptying.

Management of Pain

During labor, analgesics may be administered as required, but the amount should be kept to a minimum since they pass the placenta and may impair the newborn’s ability to breathe.

It is possible for neonatal toxicity to develop because the newborn’s metabolic and excretory mechanisms are still immature, and they are unable to eliminate the transmitted substance as quickly as adults. There is a significant reduction in the use of analgesics when women are better prepared for and educated about delivery. Management Of First Stage Labor Discussion

In order for the mother to feel most at ease, she should choose the posture she prefers.

The foetus’ descent is aided by ambulation in early labor.

Women often prefer to lean forward and rest their weight on a table or their partner’s shoulder when they are having a contraction.

A bean bag or a stroll up and down the hall may be more her speed of choice.

As a precaution, it is best for her to lay on her left side so that the inferior vena cava does not get compressed.

Back pain is alleviated by lying on all fours in the occipital posterior positions. Management Of First Stage Labor Discussion

6.Nutrition

When it comes to eating, the majority of women who are in paid work don’t care about it. In the latent period, they should be encouraged to consume. You may drink as much fluid as you want.

A steady stream of glucose is required to fuel the laborer’s muscles’ rapid contractions. Protein and fat reserves will be metabolized to give glucose if it cannot be gained from eating. Ketoacidosis is an outcome of this.

High glucose concentrations may cause prenatal hyperinsulinism and postpartum hypoglycemia by raising fetal blood glucose levels unnaturally. Management Of First Stage Labor Discussion

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Medical Attention for the Bladder

Encourage the lady to go to the bathroom at least once every two to four hours. Pregnant women should not depend on their midwives for bathroom requests, since the mother’s sense of urgency may be diminished.

Pregnancy complications may arise from the presence of urine in the bladder.

Postpartum bleeding may occur if the uterus does not contract (uterine atony) after birth.

A vescico vagina fistula may form if the bladder is damaged when full. Management Of First Stage Labor Discussion