MANAGEMENT OF NORMAL

LABOUR AND DELIVERY

Dr Nabeel Bondagji
Consultant Perinatologist
KAUH&KFSH
 LECTURE OVERVIEW
Definitions
Anatomy of the fetal head and maternal
pelvis
Management of 1st, 2nd and 3rd stages of
normal labour
monitoring of maternal well being
monitoring of fetal well-being
monitoring progress of labour
NORMAL LABOUR: Definitions

Onset of regular involuntary coordinated,

painful uterine contractions associated with
cervical effacement and dilatation
Delivery is the expulsion of the product of
the conception after fetal viability.
 TRUE LABOURVX FALES
LABOUR

Regular contractions Irregular

Increase in frequency Remain the same
and intensity
Cervix dilate Unchanged
No relive with relive
sedation
Abd and back pain Lower abd
 STAGES OF LABOUR 4
First stage cervical dilatation and
effacement
Second stage is the expulsion of the fetus
Third stage is the delivery of the placenta
Fourth stage is the early recovery
FRIEDMANS CURVE
 Management of Normal Labour

Monitor maternal well-being

Monitor fetal well-being
Monitor the progress of labour
 HOW DOES THE HEAD
NEGOTIATE THE PELVIS?

(1) change its shape and size (moulding)

(2) change its position (flexion and rotation)
ANATOMY OF THE FETAL HEAD

Largest and least compressible part of the fetus

therefore the most important obstetrically
Comprises of
(1) base of skull (ossified, non compressible, protecting brain
stem)
(2) cranium
(a) bones: occipital, 2 parietal, 2 frontal and 2 temporal
interconnected with membrane; therefore compressible
(b) sutures (where the bones meet): saggital, lambdoid, coronal
fontanelles (where the sutures meet): ant and post
The compressibility of the fetal skull means the bones can overlap
(moulding) in order for the skull to change shape negotiating the
maternal pelvis