Anatomy & Physiology (First Stage of Labour)

1. Basic Observations as detailed earlier (Blood evident in urine = normal after rupture of membranes)
2.Contractions - Fundal Dominance = when contraction begins at the top of the fundus in one of the cornua and spreads across and down. Lasts longer in the fundus where it it most intense but the peak is felt across the entire uterus. Contraction fades from all areas together (equally). This pattern permits the cervix to dilate and the sronglhy contracting fundus to expel the fetus.
3.Uterus - Polarity occurs. The upper pole contracts srongly and retracts to expel the fetus and the lower pole contracts slightly and dilates to allow expulsion to take place.
4.Cervix - Cervical Dilatation occurs as a result of uterine action and counter pressure from presenting part (or intact membranes) via fetal axis pressure. Pressure applied evenly to the cervix causes the fundus to respond by contraction and retraction
5.Passenger - Fetus flexes its head = optimal fetal position for delivery - known as flexion
6.Pain Relief - Hydrotherapy - takes pressure off joints, relaxing (Dianne Garland). Entonox - nitrous oxide, doesn't take away pain, helps focus on breathing, good distraction, helps mother to relax, no lasting effects, can promote feelings of dizziness and nausea
7.Promote regular micturition to keep bladder empty as a full bladder can prevent the uterus from contracting effectively

Resource summary

	Created by jchavner almost 11 years ago