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OG 1.4 - Normal Labour + Delivery - Jan 2015
OG 1.4 - Normal Labour + Delivery - Jan 2015
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Anatomy of the Female Pelvis
Effacement occurs when the entire length of the cervical canal has
been taken up into the lower segment of the uterus. In a
Primigravid patient, dilatation will not begin until full effacement is
complete.
Two phases:
Passive phase: From full dilatation until the head reaches the
pelvic floor.
Active phase: When fetal head reaches pelvic floor. Usually
associated with strong desire to push.
Engagement
Flexion
Descent
Internal rotation (Head has now rotated from a lateral(occipito-
transverse) position at the pelvic brim to an antero-posterior position
at the pelvic outlet.) The position of the head as it traverses the canal
is described according to the position of the occiput. The head usually
rotates from an occipitotransverse to an occipitoanterior position.
Extension (as the head delivers).
External rotation (back to transverse position, allows rotation of
shoulders to anteroposterior position.)
Expulsion
An episiotomy is a surgical
procedure in which the perineum is
cut with a scissors with the intention
of widening the soft tissue diameter
of the introitus in order to prevent a
severe perineal tear or accelerate
delivery.