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  • Events in Second & Third Stage of Labour

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    Nirupama Ks
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    The document summarizes the key events and management approaches in the second and third stages of labor. The second stage involves bearing down efforts and the descent and delivery of the fetus. Management focuses on assisting the natural expulsion of the fetus while preventing injuries. The third stage involves placental separation and expulsion, usually within 15 minutes. Management can be expectant, allowing separation and delivery to occur spontaneously, or active, using oxytocin to encourage contractions and quicker separation and delivery of the placenta.

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    events in 2nd nd 3rd stage o flabor

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    Clinica;

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    The document summarizes the key events and management approaches in the second and third stages of labor. The second stage involves bearing down efforts and the descent and delivery of the fetus. Management focuses on assisting the natural expulsion of the fetus while preventing injuries. The third stage involves placental separation and expulsion, usually within 15 minutes. Management can be expectant, allowing separation and delivery to occur spontaneously, or active, using oxytocin to encourage contractions and quicker separation and delivery of the placenta.

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    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
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    3 views18 pages

    Events in Second & Third Stage of Labour

    Uploaded by

    Nirupama Ks
    The document summarizes the key events and management approaches in the second and third stages of labor. The second stage involves bearing down efforts and the descent and delivery of the fetus. Management focuses on assisting the natural expulsion of the fetus while preventing injuries. The third stage involves placental separation and expulsion, usually within 15 minutes. Management can be expectant, allowing separation and delivery to occur spontaneously, or active, using oxytocin to encourage contractions and quicker separation and delivery of the placenta.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 18

    EVENTS IN SECOND & THIRD STAGE OF LABOUR

    Events in Second stage of Labour


    Second stage is from full dilatation of the cervix to the expulsion of the fetus. Duration - 1 hour in nullipara - half hour in multipara

    1. Bearing down pains 2. Membrane status 3. Descend of Fetus - Fifth formula 4. Maternal signs 5. Vaginal signs 6. Fetal Effects

    MANAGEMENT OF THE SECOND STAGE

    Transition from the first stage to second stage is evidenced by; - increased intensity of uterine contractions - bearing down efforts - urge to defecate - complete dilatation of cervix

    PRINCIPLES
    To assist in the natural expulsion of the fetus slowly and steadily To prevent perineal injuries

    Genaral Measures
    Patient should be in bed FHR monitoring Analgesics Vaginal examination

    Preparation for Delivery


    Position Gowning and gloving Toileting the external genitalia Catheterise the bladder

    Conduction of Delivery
    Delivery of head Delivery of shoulders Delivery of trunk

    IMMEDIATE CARE OF THE NEWBORN


    Clamping and ligature of cord Receive the baby in a clean try covered with dry linen Clear the air passage by gentle suctioning APGAR rating at 1 mt and 5 mt Quick check to detect any abnormalities

    Events in Third stage of Labour


    Stage of placental separation and expulsion Duration - 15 mts.

    Methods of Placental separation


    1. Central Separation / Schultz method - formation of retroplacental hematoma 2. Marginal Separation / Mathew Duncun - most common

    Management of 3rd stage

    Steps of Management
    Expectant managemnet Active management

    Expectant management
    Placental separation and its descend to vagina are allowed to occur spontaneously A hand is placed over fundus - to recognise signs of placental separation - to note uterine activity - to note signs of inversion of uterus Massage uterus to make it hard ( Inj.Oxytocin 10 U or Inj.Ergometrine 0.2 mg IM ) Examination of placenta and membranes Inspection of vulva, vagina and perineum

    Expulsion of Placenta
    - Controlled Cord Traction ( modified Brandt Andrews method )

    Mechanism of Control of Bleeding


    - Living Ligatures

    Active management
    Principle - to excite powerful uterine contractions following birth of the anterior shoulder by parenteral oxytocin which facilitates not only early separation of the placenta but produces effective uterine contractions following its separation

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