Normal Labor
正常分娩
Key Words
? Retraction 缩复性
? uterine segment 子宫下段
? fontanels 囟门
? engagement 衔接
? descent 下降
? delivery 分娩
? show 见红
? partogram 产程图
? lateral episiotomy 会阴侧切术
? dilatation of cervix 宫颈口扩张
? dystocia 难产
医生，请帮帮忙！！
? 在开往沈阳的一列特快列
车上，探亲归来的你正在
欣赏着沿途美丽的风光，
列车广播员急切的声音打
断了你的思绪：“列车上
有一位孕妇临产，医生同
志请尽快赶到 8号车
厢 ……”
Help me,doctor
On a train to Shenyang,you have
just left the home town,watching
the beautiful
scenery,suddenly,broadcasting stop
the train of your thought:a
pregnant woman will bear child,if
you are a doctor,please go to No.8
coach...
问题
? 你首先怎么办？ Your first step…
? 如何判断胎儿能否娩出？ Could the child be born out?
? 如何处理才能保证母子平安？ How to make the
mother and the child safe?
Questions
Ⅰ, Definition
Delivery is the process by which the
mature or nearly mature (fetus and
placenta) are expelled from the
maternal body.
? Premature delivery,28GW – 37GW
? Term delivery,37GW – 42GW
? Postterm delivery,after 42 GW
? Agents of labor
1,Mechanical theory 机械性理论
2,Endocrine regulating theory
内分泌控制理论
3,Neurohumor theory 神经介质理论
? Factors affecting labor.
There are four factors affecting
labor,expulsive force,the fetus (lie,
position and presentation of fetus),
passage (the bony pelvis and soft
tissue),and psychological factors.
If the four factors accommodate
each other,the fetus may be easily
delivery,otherwise difficult delivery
may occur.
1,The powers 产力
1) uterine contraction
rhythm 节律性
symmetry 对称性
polarity 极性
retraction 缩复作用
2) abdominal muscles and
diaphragm 腹肌、膈肌
3) levator 肛提肌
2,Birth canal 产道
1) bony pelvis 骨产道
pelvic inlet plane 骨盆入口平面 (前后
11cm,横 13cm,斜 12.75cm)
Mid plane of pelvis 中骨盆平面
Pelvic outlet plane 骨盆出口平面
(1) 9cm
(2) 6cm
(3) 8.5cm
(4) 11.5
(2)+(3) > 15cm
2) the soft part of the birth canal
软产道
formation of lower segment
changes in the cervix
changes in the floor of pelvis,
vagina and perineum
3,The fetus 胎儿
1) size of the fetus
2) position of the fetus 胎位
3) abnormality of the fetus 胎儿畸形
4,Psychological factors 精神心理因素
Ⅳ, The mechanism of normal labor in vertex
presentation
1,Engagement 衔接
2,Descent 下降
3,Flexion 俯屈
4,Internal rotation 内旋转
5,Extension 仰伸
6,Restitution and external rotation 复位、外旋转
7,Expulsion of fetus 胎儿娩出
Ⅴ, Threatened labor and in labor
1,Threatened labor 先兆临产
1) false labor 假临产
2) lightening 胎儿下降感
3) show 见红
2,In labor 临产 (sign,regular
uterine contraction with cervix
dilatation and descent )
3.Total stage of labor 总产程
1,The first stage or dilatation of the
cervical OS 初产妇 11－ 12h
经产妇 6－ 8h
2,The second stage or expulsion of
the fetus 初产妇 1－ 2h
经产妇 数分钟－ 1h
3,The third stage or expulsion of the
placenta 5－ 15min
? Clinical course and treatment
in first stage
1,Uterine contraction 子宫收缩
2,Fetal heart rate
3,Dilatation of the cervix and
descent of the fetal head
4,Rupture of membranes
5,General menagement
? Clinical course and treatment in
second stage
1,Clinical findings (head visible on
vulval gapping; crowning of head)
2,Treatment
Episiotomy
新生儿处理
? 1.清理呼吸道
? 2.处理脐带
? 3.Apgar 评分, 皮肤颜色、呼吸、肌张
力、反射、心率
? Clinical course and treatment in
third stage
1,Clinical findings
2,treatment
胎盘剥离征象,
正常分娩
Key Words
? Retraction 缩复性
? uterine segment 子宫下段
? fontanels 囟门
? engagement 衔接
? descent 下降
? delivery 分娩
? show 见红
? partogram 产程图
? lateral episiotomy 会阴侧切术
? dilatation of cervix 宫颈口扩张
? dystocia 难产
医生，请帮帮忙！！
? 在开往沈阳的一列特快列
车上，探亲归来的你正在
欣赏着沿途美丽的风光，
列车广播员急切的声音打
断了你的思绪：“列车上
有一位孕妇临产，医生同
志请尽快赶到 8号车
厢 ……”
Help me,doctor
On a train to Shenyang,you have
just left the home town,watching
the beautiful
scenery,suddenly,broadcasting stop
the train of your thought:a
pregnant woman will bear child,if
you are a doctor,please go to No.8
coach...
问题
? 你首先怎么办？ Your first step…
? 如何判断胎儿能否娩出？ Could the child be born out?
? 如何处理才能保证母子平安？ How to make the
mother and the child safe?
Questions
Ⅰ, Definition
Delivery is the process by which the
mature or nearly mature (fetus and
placenta) are expelled from the
maternal body.
? Premature delivery,28GW – 37GW
? Term delivery,37GW – 42GW
? Postterm delivery,after 42 GW
? Agents of labor
1,Mechanical theory 机械性理论
2,Endocrine regulating theory
内分泌控制理论
3,Neurohumor theory 神经介质理论
? Factors affecting labor.
There are four factors affecting
labor,expulsive force,the fetus (lie,
position and presentation of fetus),
passage (the bony pelvis and soft
tissue),and psychological factors.
If the four factors accommodate
each other,the fetus may be easily
delivery,otherwise difficult delivery
may occur.
1,The powers 产力
1) uterine contraction
rhythm 节律性
symmetry 对称性
polarity 极性
retraction 缩复作用
2) abdominal muscles and
diaphragm 腹肌、膈肌
3) levator 肛提肌
2,Birth canal 产道
1) bony pelvis 骨产道
pelvic inlet plane 骨盆入口平面 (前后
11cm,横 13cm,斜 12.75cm)
Mid plane of pelvis 中骨盆平面
Pelvic outlet plane 骨盆出口平面
(1) 9cm
(2) 6cm
(3) 8.5cm
(4) 11.5
(2)+(3) > 15cm
2) the soft part of the birth canal
软产道
formation of lower segment
changes in the cervix
changes in the floor of pelvis,
vagina and perineum
3,The fetus 胎儿
1) size of the fetus
2) position of the fetus 胎位
3) abnormality of the fetus 胎儿畸形
4,Psychological factors 精神心理因素
Ⅳ, The mechanism of normal labor in vertex
presentation
1,Engagement 衔接
2,Descent 下降
3,Flexion 俯屈
4,Internal rotation 内旋转
5,Extension 仰伸
6,Restitution and external rotation 复位、外旋转
7,Expulsion of fetus 胎儿娩出
Ⅴ, Threatened labor and in labor
1,Threatened labor 先兆临产
1) false labor 假临产
2) lightening 胎儿下降感
3) show 见红
2,In labor 临产 (sign,regular
uterine contraction with cervix
dilatation and descent )
3.Total stage of labor 总产程
1,The first stage or dilatation of the
cervical OS 初产妇 11－ 12h
经产妇 6－ 8h
2,The second stage or expulsion of
the fetus 初产妇 1－ 2h
经产妇 数分钟－ 1h
3,The third stage or expulsion of the
placenta 5－ 15min
? Clinical course and treatment
in first stage
1,Uterine contraction 子宫收缩
2,Fetal heart rate
3,Dilatation of the cervix and
descent of the fetal head
4,Rupture of membranes
5,General menagement
? Clinical course and treatment in
second stage
1,Clinical findings (head visible on
vulval gapping; crowning of head)
2,Treatment
Episiotomy
新生儿处理
? 1.清理呼吸道
? 2.处理脐带
? 3.Apgar 评分, 皮肤颜色、呼吸、肌张
力、反射、心率
? Clinical course and treatment in
third stage
1,Clinical findings
2,treatment
胎盘剥离征象,
