3Changes during the last week of pregnancy Mood swingFetal changes : fetal in the lower site 2-3 wkExpansion of lungsEasy breathingWoman feel more comfortSoften and lightningIncrease effacementDifficult walkingBack painIncrease the pressure within the pelvises and vag. secr.
4The onset of spontaneous labour First StageLatent phase: cervix dilated about 3-4cm this phase stay 6-8 hrthis phase started before the active phaseActive phase: cervix is more dilated. Started when cervix about 4cm with regular uterine cont.Transitional Phase: cervix dilated around 8cm -10cm.The onset of spontaneous labourWomen have to be informed and feel comfort good labor preparation, explain and provide privacy, good management.
5Spurious ( false) Labour Contraction before onset of labour Contraction may be regularNo cervical dilationNo effacementNo true labourMedical and Midwifery Management:SupportIncrease a awarenessReassuranceDiscussion for future managementEffacement mean that the cervix merge into the uterine segment
7Complete effacement include internal and external cervical os Complete effacement include internal and external cervical os. This happen by the action of combination of hormonal and mechanical factors.Action of estrogenIncrease oxytocin receptors releaseStimulate placenta for H. production (progest.)Increase softening of cervix
8What is the onset of labour Is the process of establishing true labourIt is difficult to determineDiagnosis of onset of labour is important in order to make correct managementPhysiology of first stage of laborDuration vary and affected by: parity, birth interval, psychological status and position of fetusUterine ContractionFundal dominanceCont. started in the conrea and spread cross and down
9Uterine Contraction Fundal dominance Polarity Contraction and retractionFormation of upper and lower uterine segmentThe retraction ringCervical effacementCervical dilationShow