STAGE OF LABOUR

PRESENT BY :
FATIN NASHUHA
NUR EZEIYAN
NURFATIN ASHIKIN
NURUL NADIA
DEFINITION OF LABOUR
 The process by which the fetus, placenta and membranes are expelled
through the birth canal.

 NORMAL LABOUR occur at term and is spontaneous in onset with the

fetus in vertex presentation. The process is completed within 18 hours and no
complication arise.
 1. 1st Stage
Begin with regular contraction
until cervix is fully dilated.
Divided into latent, active, and
transition phase.

2. 2nd Stage.
Begin from fully dilatation of
3 STAGES cervix until delivery of fetus/baby.

3. 3rd Stage.
Begin from delivery of fetus/baby
until delivery of placenta.
  THE FIRST STAGE IS THE LONGEST
FOR ALMOST EVERYONE, BUT ITS
LENGTHS IS VARIABLE.

 1 HOUR UNTIL 20 HOURS

(PRIMIPARA), 5 UNTIL 14 HOURS

FIRST (MULTIPARA) IS NORMAL.

STAGE  STARTING WITH REGULAR

CONTRACTION UNTIL CERVIX IS
FULLY DILATED.

 DIVIDED BY 3 PHASE :
1. Latent phase – 0-4 cm dilatation of
cervix.
2. Active phase – 4cm until cervix is
fully dilated.
3. Transition phase – 8cm-fully dilated
until excessive urge to push.
  BEGINS WHEN THE CERVIX IS
FULLY DILATED AND ENDS WITH
DELIVERY OF BABY.

 DIVIDE INTO :
1.Latent phase – begin from full cervix

SECOND dilatation to crowning.

STAGE
2.Active phase – head is visible
( crowning ).
- extremely urge
to push.
  BEGIN WITH THE BIRTH OF THE
BABY AND ENDS WITH DELIVERY
OF PLACENTA.

 NORMALLY LAST FROM 5-20 MINS

( UP TO 1 HOUR ).

THIRD  SIGN OF SEPARATION AND

STAGE DESCENT OF PLACENTA :

Gush of blood.
Lengthening of cord.
Change of uterus shape.
( hard,globular, and mobile )
PATHOGRAM
 Is graphical information about the progress
of labor

WHAT IS Record all observations made on a woman

and fetus in labor in one chart

PATHOGRAM?
Helps to identify at an early stage those
women labor is slow

For prevention of prolonged labor

 EXAMPLE OF
PATHOGRAM

20XX presentation title 10

WHAT NEED TO
BE RECORD?
Fetal well being
• Fetal heart rate
• Character of liquor
• Moulding

Labour progress
• Dilatation
• Descent
• Uterine Contraction

Medication
• Oxytocin
• Pain relief e.g: IM Pethidine

Maternal well being

• BP, Pulse, Temperature
• Urine - glucose, protein,
acetone
• Urine output
 FETAL
INFORMATION
• Fetal heart rate (110bpm -
160bpm)
• Membrane and amniotic fluid
• Moulding
 CHARACTER OF AMNIOTIC FLUID

1. State of liquor can assess in

monitoring fetal condition
2. Membrane Intact record as – “MI”
3. Membrane ruptured:
• Clear liquor record as – “C”
• Meconium stained record as –
“MS”
• Blood stained record as – “B”

20XX presentation title 14

 MOULDING OF FETAL SKULL

1. Provide information about the adequacy of

the pelvis to accommodate fetal head
2. Record the degree of moulding

O : bones separated
+ : bones touching but can be separated
++ : bone overlapping
+++:bones overlapping severely
 DILATATION AND DESCENT

1. Latent (0-4 cm) and Active (4-10 cm)phase.

2. The first vaginal examination done on admission
is recorded.
3. Subsequent vaginal examination is done every 4
hourly
4. Transfer from latent to active phase.
 UTERINE CONTRACTION

1. Assess the frequency duration.

2. Each square represent 1 contraction felt in
10 minutes
3.Duration – Shade the contraction in the
square
 MOTHER WELL BEING

• BP, Pulse, Temperature

• Urine - glucose, protein, acetone
• Urine output