Keeping childbirth - a tactic , technique

final stage of any pregnancy is delivery.The correctness of the management of labor largely determines the state of the mother and child health in the future.During birth the medical staff to take timely and appropriate measures to avoid many complications.That is why in our country labor, usually performed in specialized establishments equipped with all necessary equipment.

labor management tactics has traditionally expectantly-active, ie in the course of delivery is not only closely monitored, but also the prevention and correction of deviations occur, and an emergency delivery is used when necessary.

main periods of labor

The jurisdiction of physiological childbirth, there are three periods, with each of them medical personnel to adhere to certain tactics of childbirth:

  • first stage of labor.For the duration of this stage of labor is the longest - from 8 to 16 hours, and sometimes more.The beginning of the first stage of labor is the appearance of contractions at regular intervals, which are gr
    adually becoming more frequent.There is a slow opening of the cervix, as well as the formation of the birth canal.Minimum speed with which the cervix is ​​- 1 cm per hour.Discharge of amniotic fluid occurs in the first stage of labor.When protracted course for induction of labor is administered oxytocin and amniotomy is performed (puncturing the bladder);
  • second stage of labor.The duration of this period is 1 - 2 h.The contractions are replaced by vain attempts, there is expulsion of the fetus.In the first hour of the head, gradually descending, reaches the pelvic floor.An hour later she was born, and then there are the shoulders and the body of the newborn immediately.To prevent perineal tears during the complicated passage of the head, carried episiotomy - incision of the perineum;
  • third stage of labor.The duration of the third period of not more than 10 - 30 minutes, during which there is a passage of the placenta and fetal membranes.If this process is delayed, use manual removal of the placenta.The risk of bleeding is possible in the last period.

When conducting physiological delivery should also take into account the following features: the woman's age, the volume of the uterus and the fetal position, the first and second generations.All these features are very important and help to choose the best tactics of labor management in each period.

labor management tactics in the first period

woman is in the prenatal ward, general hygiene (enema, shower, shaving) it previously held.

systematically in the external obstetric research period disclosure is made, there is a state of the uterus in the battles, as well as outside them.Every two hours, made entries in the history of labor management, and every 15 minutes the doctor listens to the heartbeat of the fetus.Observation of the progressive baby's head through the birth canal by using the following methods:

  • External palpation techniques;
  • vaginal examination;
  • Listening to the heartbeat of the fetus;
  • Ultrasonography.

If contractions have mothers too painful, it is recommended to maintain anesthesia mutual reduction of the upper and lower segments of the uterus and prevent fractures in cervical delivery.

delivery Keeping in the first period does not imply strict adherence to bed rest.She can walk, sit, rocking in a rocking chair, etc.All this is quite possible, if there is no obstetric or extragenital pathologies.

Management of second stage of labor

When the cervix is ​​fully dilated, begins the second stage of labor.Uterine contractions become more frequent and extended, the fetal head rotates, moving through the birth canal.Woman in labor feel a lot of pressure in the rectal area, as well as pain in the legs and pelvis.Short relaxation periods are replaced by strong vain attempts.

women in childbirth regularly measure blood pressure and other indicators, as well as the need to carry out anesthetic.All data entered in the partograph.Target management tactics can change it in the second period.It depends on the state of women in labor, active labor and the duration of the course of the period.

here in the first place comes the experience of the medical staff and the individual management of labor.As soon as the head midwife preparing to receive the fetus and begins to help his birth, at the same time trying to prevent tears from mothers, for example, performing an episiotomy.

Once born head, the doctor will determine whether or not there entanglement, and when it is detected trying to dislodge the cord down.By using certain methods of delivery management helps obstetrician appear one hanger, and then another.Then there is a newborn calf and foot.From the mouth and nose of the child aspirated mucus, and the eyes are washed with sterile water.Toddler at a time is placed between the mother's legs, so that part of the placenta through the umbilical cord blood came out to him.After about 3 minutes the umbilical cord is cut and the child takes the first breath and screams.At the same time the condition of the newborn evaluated by the Apgar score.The child is examined to identify possible pathologies and then placed on the mother's abdomen for the first lactation.

Maintaining physiological delivery in the third period

order not to disturb the natural course of labor, in the third period is prohibited to palpate the uterus, or the right of the placenta does not happen.When the placenta separates yourself in a natural way, the risk of bleeding is minimal.

tactics of labor management in this period is reduced to waiting.The doctor monitors the color of skin mothers, pulse and blood pressure.It is also necessary to observe the bladder: a crowded bladder reduces the contraction of the uterus, and thus disrupted the normal flow of the placenta.

At this point, management of labor maternity offer a tighter, however, if the birth of the placenta and does not occur, the obstetrician has resorted to a method for external retrieval.Attempts to isolate the last before the placenta separates, is strictly prohibited.

next important task - examination of the vaginal walls and the cervix.If you find gaps impose catgut sutures.The integrity of the perineum following episiotomy or her injuries also reduced by suturing.

After the discharge of the placenta becomes a new mother postpartum women, there comes the post-natal period.Within two hours puerpera still in the maternity ward under the care of doctors and midwives who monitor her general condition.Two hours later, the woman transferred to the postnatal ward.

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