Introduction
Definition :
Series of events that take place in the genital organs in an effort to expel the viable products of conception out of womb through vagina into the outer world is called as labour.
Normal labour is called eutocia
CRITERIA FOR NORMAL LABOUR :
1) Spontaneous in onset and in term.
2) With vertex presentation
3) Without undue prolongation
4) Natural termination with minimal Aid.
5) Without having any complication affecting health of mother or baby.
Deviation from definition of normal labour is called as dystocia I.e. abnormal labour.
Certain terms related to labour:
1) preterm labour :
labour prior to 37 completed weeks.
2) Mini Labour:
Expulsion of pre-evitable fetus occurs through same process but in a miniature form called as mini labour
3) Parturient :
Is a patient in labour.
4) Parturition:
Is the process of giving birth.
5) Delivery:
Is the expulsion or extraction of a viable fetus out of womb. It is not Synonymous with labour because Delivery may be vaginal, Spontaneous, or abdominal.
Causes of onset of labour:
1) Uterine Distension
Stretching effect on the myometrium by growing fetus can facilitates onset of labour e.g. this is more effective on twins and polyhydramnios.
2) Feto Placental contribution:
Fetal hypothalamus
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CRF
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Stimulates fetal pituitary
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Increased ACTH
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Stimulates fetal adrenals
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Glucocorticoid
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Stimulates placenta
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Increased prostaglandins and oestrogen
3) Oestrogen:
1) Increased release of oxytocin from maternal pituitary
2) Promotes the synthesis of receptors for oxytocin in the myometrium and deciduas
3) increases prostaglandins synthesis.
4) Stimulates myometrial contractile elements
🎀Actin
🎀Myocin
5) Increases excitability of myometrial cell membrane.
6) Oxytocin :
A) Increased synthesis of oxytocin receptors
B) Increased synthesis of oxytocin ( from posterior pituitary, decidua and placenta.)
C) oxytocin increases action and release of Pg (oxytocin level reaches the maximum at the moment of birth).
7) Neurological factors:
Nerve-
Pathways play important role in contraction of myometrium.
Both alpha and beta adrenergic receptor present in the myometrium.
(Alpha - receptor Stimulates.)
(Beta - receptor inhibits contraction)
Contractile system/ Factors responsible for contraction of myometrium;
1) Actin
2) Myocin
3) ATP
4) Enzyme - MLCK - Myocin light chain kinase
5) Calcium ions
Effects of Contraction of uterus - I.e. Pains (Types of pains)
A) False pain : (False labour, spurious labour)
1) found more in primigravida
2) Appears prior to the onset of true labour pains, by one or two weeks in primigravida and few days in multiparae.
Women feels pain and discomfort in abdomen which has following characters:
A) Dull in nature , confident to lower abdomen and groin.
B) Continuous and unrelated with hardening of the uterus.
C) dilation of cervix does not associate
D) Relieved by enema and administration of a sedative.
Cause of false pain ;
Stretching of cervix and lower uterine segment. With irritation of the neighbouring ganglion.
B) TRUE LABOUR PAINS ;
Shows following characters :
1) Painful uterine contractions at regular intervals felt often infront of abdomen OR radiating towards thigh
2) Contraction with increasing intensity and duration.
3) Show -
with the onset of labour there is profuse cervical secretion.
Also there is light oozing of blood from ruptured capillary vessels of the cervix and deciduas. (Expulsion of cervical mucous plug mixed with blood is called as show)
4) Progressive dilation of cervix (internal os)
5) Formation of the bag of membrane (bag of water)
In this comprehensive overview of normal labor, we have explored its stages, physiological processes, and key aspects to understand this natural and remarkable event. From the onset of labor to delivery and postpartum care, every phase is vital for ensuring the well-being of both mother and baby, offering valuable insights into the normal labor process. Thank you for reading, and we hope this information proves beneficial for your knowledge and practice.
Good info 😍
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