Normal labour

1. MECHANISM OF NORMAL LABOUR
Alexandria faculty of medicine
Rania Hesham Abd El-Galil

2. Normal labour
criteria of normal labour
 Spontaneous expulsion
 of a single
 full term
 Living & viable
 presented by vertex,
 Through normal passage
 within a reasonable time
 without major surgical intervention
 without complications to the mother,
or the fetus

3. Onset of N.Labour
True Labour pain
“crietria”
The “show”
Uterine contractions
Cervical effacement,
Dil. &formation of fore
waters

4. Stages of Normal Labour

5. The first stage

6. The first stage
1-Cervical effacement

7. The first stage
 Cervical dilatation

8. The second stage
 Mechanism of n.labour
Descend
Flexion
Internal rotation
Crowning
Extension
Restitution
Internal rotation of shoulder
External rotation of head
Lateral flexion of body
Delivery

9. The second stage
 Descent
 Synclitism
 (asynclitism-posterior parietal bone presentation-Litzmann’s
obliquity).
 (asynclitism-anterior parietal bone presentation-Naegele’s
obliquity).

10. The second stage
 Engagement
 Station zero

11. The second stage
 Increased flexion
Occipitofrontal diameter Suboccipitobregmatic
diameter
>
flexion

12. The second stage
 Internal rotation

13. The second stage
 Extension

14. The second stage
 Restitution and external rotation

15. The second stage
 Delivery of the shoulders & expulsion

16. The second stage

17. The Third stage
 Placenta delivery

19. The third stage
1- Mathews-Duncan mechanism
The leading edge of the placenta
separates first and the placenta
is delivered with its rawsurface
exposed.
2- Schultz mechanism
If the placenta is inserted at the
fundus and central area
separates first, the placenta
inverts and draws the
membranes after it, covering the
raw surface (inverted umbrella)

20. Management of the labour “2nd
stage”
 DELIVERY OF THE HEAD
1) Control the delivery of the head to prevent laceration
2) Performed episiotomy if requires
3) Performed Ritgen’s method
4) Cleared the airway after delivery of the had

21. Management of the labour “2nd
stage”
 EPISIOTOMY
"..is a surgical incision into the perineum to enlarge the
space at the outlet

22. Management of the labour “2nd
stage”
 Repair of Episiotomy
Continuous sutures Interrupted sutures Interrupted
suture or
subcuticular