NCM 101 Lecture Notes MIDTERMS Handout 6 _____________________

PREPARATION FOR CHILDBIRTH AND PARENTING: 1. Perennial and Abdominal Exerci e : To !ren"!#en abdominal and $el%ic m& cle Allo' !re!c#in" d&rin" c#ildbir!# and !#e (a !er i! re%er! !o i! normal condi!ion a(!er'ard ). Tailor *i!!in": Allo' !re!c#in" o( !#e $erennial m& cle o !#a! blood &$$l+ !o !#e lo'er ex!remi!ie i no! occl&ded ,. *-&a!!in": Al o !re!c#e !#e $erennial m& cle o a $re"nan! 'oman #o&ld $rac!ice -&a!!in" (or a!ea ! 1. min dail+. T#i al o allo' !re!c#in" o( !#e $el%ic m& cle / !#e n&r e a &re !#a! !#i i done correc!l+ b+ in !r&c!in" !#e $a!ien! !o 0ee$ #er (ee! (la! on !#e (loor '#ile -&a!!in". 1. 2e"el3 exerci e .. Abdominal 4& cle Con!rac!ion : *!ren"!#enin" abdominal m& cle d&rin" $re"nanc+ #el$ re !ore abdominal !one a(!er $re"nanc+ T#i #el$ !#e $a!ien! !o #a%e a more e((ec!i%e econd !a"e o( labor. 5. Pel%ic Roc0in": T#i #el$ relie%e bac0ac#e d&rin" $re"nanc+ and in earl+ labor b+ ma0in" !#e l&mbar $ine more (lexible T#e mo!#er i in !r&c!ed !o al o arc# #er bac0/ and #old !#e $o i!ion (or 1 min&!e.

ADDITIONAL READING ASSIGNMENT: DEFINITION OF TER4*: 1. Par!&ri!ion: c#ildbir!#/ bir!#in" ). $ar!&rien!: a 'oman in labor ,. Labor: a coordina!ed e-&ence o( in%ol&n!ar+ &!erine con!rac!ion !#a! re &l! in e((acemen! and dila!ion o( !#e cer%ix and %ol&n!ar+ bearin" do'n e((or! !#a! re &l! !#a! re &l! in deli%er+ '#ic# i !#e ac!&al ex$&l ion o( !#e $rod&c! o( conce$!ion 7 !#e (e!& and !#e $lacen!a8 1. E&!ocia: Normal Labor .. Prodromal Labor: earl+ or $remoni!or+ mani(e !a!ion o( im$endin" labor be(ore !#e on e! o( !r&e labor FACTOR* INFL6ENCING LABOR: 1. &!erine m& cle !re!c#in" ). $re &re on !#e cer%ix ,. ox+!ocin !im&la!ion 1. c#an"e in ra!io o( e !ro"en and $ro"e !erone .. $lacen!al a"e 5. (e!al $rod&c!ion o( $ro !a"landin THEORIE* OF LABOR ON*ET: 1. 6!erine *!re!c# T#eor+: An+ #ollo' or"an '#en !re!c#ed !o i! maxim&m ca$aci!+ 'ill con!rac! and em$!+ d&e !o $re &re o( ner%e endin" and increa e in !#e irri!abili!+ o( !#e &!erine m& c&la!&re.
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Ms. April Anne D. Balanon

NCM 101 Lecture Notes MIDTERMS Handout 6 _____________________

). Ox+!ocin *!im&la!ion T#eor+: Beca& e labor i con idered a !re (&l e%en!/ !#e #+$o$#+ i i !im&la!ed !o ini!ia!e !#e $rod&c!ion o( ox+!ocin b+ !#e $i!&i!ar+ "land '#ic# i 0no'n !o !im&la!e &!erine con!rac!ion . ,. Pro"e !erone De$ri%a!ion T#eor+: A decrea e in $ro"e !erone i 0no'n !o !im&la!e &!erine con!rac!ion 1. Pro !a"landin T#eor+: A decrea e in $ro"e !erone and a $redominance o( e !ro"en !im&la!e !#e $rod&c!ion o( cor!ico !eroid '#ic# ac! on li$id $rec&r or !o relea e arac#idonic acid and in !&rn increa e !#e +n!#e i o( $ro !a"landin '#ic# !im&la!e &!erine con!rac!ion .. T#eor+ o( A"in" Placen!a: A decrea e in !#e n&!rien! and blood &$$l+ !o !#e a"in" $lacen!a ca& e &!erine con!rac!ion PRELI4INAR9 *IGN* OF LABOR: 1. Li"#!enin": !#e de cen! o( !#e (e!al $re en!in" $ar! in!o !#e $el%i occ&r a$$roxima!el+ 1:;11 da+ or 1;) 'ee0 be(ore labor be"in / ca& in" relie( (rom abdominal !i"#!enin" and dia$#ra"ma!ic $re &re o re $ira!ion become ea ier. Li"#!enin" al o re &l! !o: *#oo!in" $ain do'n !#e le" d&e !o com$re ion and $re &r on !#e cia!ic ner%e Increa e in lordo i a !#e (e!& (all (&r!#er (or'ard in!o !#e $el%i An increa e amo&n! o( %a"inal di c#ar"e An increa e in &rinar+ (re-&enc+ ). Increa e in !#e le%el o( Ac!i%i!+: d&e !o an increa e in !#e ener"+ le%el o( !#e mo!#er in con!ra ! !o '#a! #e 'a (eelin" $re%io& l+ beca& e o( an increa e in e$ine$#rine relea e !#a! i ini!ia!ed b+ a decrea e in $ro"e !erone. ,. Brax!on Hic0 Con!rac!ion : $ainle irre"&lar in!ermi!!en! con!rac!ion o( !#e &!er&

1. Ri$enin" o( !#e Cer%ix: 7 Goodell3 *i"n8 T#e cer%ix become b&!!er o(! *IGN* OF TR6E LABOR A. 6!erine Con!rac!ion : be"in irre"&larl+ b&! !#e+ become re"&lar and $redic!able/ (el! (ir ! in !#e lo'er bac0 and 'ee$ acro !#e abdomen in a 'a%e/ !#e e con!rac!ion con!in&e no ma!!er '#a! !#e 'oman3 ac!i%i!+ i . T#e+ increa e in d&ra!ion/ (re-&enc+/ and in!en i!+ leadin" !o ac!i%e cer%ical dila!ion. 6!erine con!rac!ion are con idered !#e &re ! i"n o( !r&e labor. , PHA*E* OF 6TERINE CONTRACTION*: 1. CRE*CENDO: 7 Incremen!8 Lon"e ! $#a e In!en i!+ o( con!rac!ion increa e Lon"er !#an !#e o!#er $#a e combined ). AC4E 7a$ex8 Hei"#! or $ea0 o( !#e con!rac!ion ,. DECRE*CENDO 7decremen!8 Decrea e in !#e in!en i!+ o( con!rac!ion

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Ms. April Anne D. Balanon

NCM 101 Lecture Notes MIDTERMS Handout 6 _____________________

B. Blood+ *#o': a !#e cer%ix o(!en / and ri$en / !#e m&c& $l&" 7 OPERC6L648 !#a! (illed !#e cer%ical canal d&rin" $re"nanc+ i ex$elled. T#e ex$o ed cer%ical ca$illarie ee$ blood a a re &l! o( $re &re exer!ed b+ !#e (e!& . T#e blood mixed 'i!# m&c& !a0e on a $in0 !in"ed 7!#& !#e !erm Blood+ *#o'8 C. R&$!&re o( 4embrane : !#i i a &dden or can!+ lo' ee$in" o( clear (l&id (rom !#e %a"ina COLOR* OF A4NIOTIC FL6ID AND <HAT THE9 INDICATE Clear and colorle Normal <i!# <#i!e *$ec0 =ernix Ca eo a Greenin # 4econi&m *!ained 9ello' Blood Incom$a!ibili!ie Pin0 Bleedin" I4PORTANT CON*IDERATION*: Once r&$!&red/ labor i ine%i!able beca& e &!erine con!rac!ion 'ill occ&r 'i!#in !#e nex! )1 #o&r I( labor doe no! occ&r/ !#e doc!or #a !o be in(ormed. Once membrane #a%e r&$!&red/ &mbilical cord com$re ion ma+ occ&r/ e $eciall+ in breec# $re en!in" babie An+ in!ra&!erine in(ec!ion can lead !o (e!al #+$oxia <HAT TO DO: 1. a e (e!al #ear! !one ). Cord Prola$ e: Po i!ion !#e $a!ien! in !rendelenb&r". *ec&re aline and "a>e !o $re%en! dr+in" o( !#e cord HO< TO DIFERENTIATE TR6E =* FAL*E LABOR: TRUE ALSE Irre"&lar a! (ir ! b&! become re"&lar and $redic!able Remain irre"&lar 'i!#in a ma!!er o( #o&r Fir ! (el! in !#e lo'er bac0 !#en 'ee$ aro&nd !o !#e Generall+ con(ined in !#e abdomen and doe no! abdomen in a "irdle li0e (a #ion radia!e !o !#e bac0 Increa e in loca!ion/ d&ra!ion/ and in!en i!+ No increa e in d&ra!ion and in!en i!+ T#e+ con!in&e no ma!!er '#a! le%el o( ac!i%i!+ Di a$$ear '#en !#e 'oman amb&la!e mo!#er i in Accom$anied b+ cer%ical e((acemen! and dila!a!ion No cer%ical c#an"e D. EFFACE4ENT Proce b+ '#ic# !#e ex!ernal cer%ical O* enlar"e (rom a (e' millime!er 'ide !o 1:cm (&ll dila!a!ion E. 6TERINE CHANGE* T#e &$$er &!erine e"men! become %er+ !#ic0 and ac!i%e. I! i !#e onl+ $ar! o( !#e &!er& !#a! con!rac! in order !o ex$el !#e (e!& (rom !#e &!er& . Lo'er &!erine e"men! become !#in 'alled o !#a! !#e (e!& can be $a ed and $& #ed ea il+ !#ro&"# !#e bir!# canal. CO4PONENT* OF LABOR: 1! "assen#er Fe!& Placen!a FACTOR* AFFECTING THE PA**ENGER: a. Fe!al Lie: de cribe !#e rela!ion #i$ o( !#e lon" axi o( !#e (e!& !o !#e lon" axi o( !#e mo!#er 7 $ine8 Lon"i!&dinal 7 #ead? breec#8 Tran %er e
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Ms. April Anne D. Balanon

NCM 101 Lecture Notes MIDTERMS Handout 6 _____________________

b. $re en!a!ion: re(er !o !#e $or!ion o( !#e (e!& !#a! en!er !#e $el%i (ir ! 7 ce$#alic/ Breec#/ or *#o&lder8 c. A!!i!&de: !#e rela!ion #i$ o( !#e (e!al bod+ $ar! !o eac# o!#er. 7(e!al $o i!ion: arm cro ed o%er !#e !#orax/ and !#e &mbilical cord lie be!'een !#e arm and !#e le" . d. Po i!ion: !#e rela!ion #i$ o( !#e (e!al re(erence $oin! !o one o( !#e 1 -&adran! o( !#e ma!ernal $el%i . Materna$ %e$&'s s'de R; Ri"#! L; Le(! eta$ re(erence %o'nt *C; *ca$&la O; Occi$&! 4; 4en!&m B; Bro' *; *acr&m Materna$ %e$&'s )uadrant T; Tran %er e 7 ide8 A; An!erior 7 Fron!8 P; Po !erior 7 Bac08

*! "assa#e: T#e bir!# canal i com$o ed o( !#e bon+ $el%i / cer%ix/ and !#e %a"ina. T#e $el%i i e$ara!ed in!o ) b+ !#e brim/ !#e !r&e $el%i and !#e (al e $el%i . T#e (al e $el%i i !#e $ar! abo%e !#e brim. T#e !r&e $el%i #a , $lane : Pel%ic inle! 7brim8 Pel%ic Ca%i!+ 7mid$el%i 8 Pel%ic O&!le! ,. Po'er: (orce ac!in" !o ex$el !#e (e!& and !#e $lacen!a Primar+ $o'er : in%ol&n!ar+ &!erine con!rac!ion Al o ca& e !#e de cen! o( !#e (e!& Ca& e e((acemen! and dila!ion o( !#e cer%ix A(!er !#e (ir ! !a"e o( labor/ !#e )ndar+ $o'er be"in 7 %ol&n!ar+ bearin" do'n8 1. Po i!ion o( !#e 4o!#er: &!erine con!rac!ion are !ron"er i( !#e 'oman i in an &$ri"#! $o i!ion and &!erine d&ra!ion o( labor i #or!er 7 !andin"/ 'al0in"/ and -&a!!in"8 Fre-&en! $o i!ion c#an"e (elie%e (a!i"&e and im$ro%e circ&la!ion/ and aid de cen! o( !#e (e!& in!o !#e bir!# canal. .. P +c#olo"ic Re $on e: $re%io& ex$erience / emo!ional re $on e / and readine / and &$$or! + !em are a (e' o( !#e e en!ial (ac!or !o ma0e !#e en!ire ex$erience o( bir!#in" &cce (&l and $o ible. 4ECHANI*4* OF LABOR:

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Ms. April Anne D. Balanon

NCM 101 Lecture Notes MIDTERMS Handout 6 _____________________

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Ms. April Anne D. Balanon