COMPONENTS-OF-LABOR.pptx

COMPONENTS OF LABOR 5 p’s 1. PELVIS (the PASSAGE) 2. FETUS (the PASSENGER) 3. Uterine factors (POWERS of labor) 4. a woman’s PSYCHE 5. POSITION If the 5 Components: (1) the woman’s PELVIS (the passage) is of adequate size & contour (2) the FETUS (the passe...

COMPONENTS OF LABOR 5 p’s 1. PELVIS (the PASSAGE) 2. FETUS (the PASSENGER) 3. Uterine factors (POWERS of labor) 4. a woman’s PSYCHE 5. POSITION If the 5 Components: (1) the woman’s PELVIS (the passage) is of adequate size & contour (2) the FETUS (the passenger) is of appropriate size & in an advantageous position & presentation (3) the uterine factors (powers of labor) are adequate (4) her (Position) is comfortable and facilitates the labor process (5) the woman’s PSYCHE is preserved so that afterward, labor can be viewed as a positive experience PASSAGEWAY or PASSAGE (PELVIS) Refers to the route a fetus must travel from the uterus through the cervix & vagina to the external perineum It is the mother’s bony pelvis and soft tissues of the cervix, pelvic floor, vagina and introitus FUNCTIONS Support & protect the reproductive & other pelvic organs Accommodation of the growing fetus Anchorage of the pelvic support structures Divisions of the Pelvis: FALSE PELVIS- upper half which supports the uterus during the late months of pregnancy & aids in directing the fetus into the true pelvis for birth TRUE PELVIS- lower half of the pelvis; long, bony, curved canal divided into 3 parts: inlet, pelvic cavity, and outlet LINEA TERMINALIS or BRIM- imaginary line from the sacral promontory to the superior border of the SP which divides the pelvis into true & false pelves Composition Anterior & lateral portion made up of 2 innominate hip bones divided into 3 parts (ilium, ischium and pubis) Posterior portion: sacrum, coccyx Types of Female Pelvic Shapes Gynecoid pelvis “female” Has an inlet that is well-rounded and has a wide pubic arch Ideal for childbirth Android “male” The pubic arch forms an acute angle, making the lower dimensions of the pelvis extremely narrow A fetus may have difficulty exiting from this type of pelvis Anthropoid- “APE-LIKE” It’s transverse diameter is narrow; the anteroposterior diameter of the inlet is larger than usual. Even though the inlet is large, the shape of the pelvis does not accommodate a fetal head as well as the gynecoid pelvis Platypelloid – “Flattened” (oval) It has a smoothly-curved oval inlet, but the anteroposterior diameter is shallow. A fetal head might not be able to rotate to match the curves of the pelvic cavity ESTIMATING PELVIC SIZE (PELVIMETRY) 2 important pelvic measurements to determine the adequacy of the pelvic size: the DIAGONAL CONJUGATE (anterior-posterior diameter of the inlet) the TUBERO-ISCHIAL or BI-ISCHIAL DIAMETER (transverse diameter of the outlet) DC (Diagonal conjugate) is the narrowest diameter of the inlet & the (TD) Tubero-ischial Diameter is the narrowest diameter of the outlet (11.5 cm) TD of pelvic cavity/inter-spinous diameter= 10 cm TD of outlet/bi-ischial diameter= 11.5 DIAGONAL CONJUGATE= 10.5 - 11 cm. It is the measurement between the anterior surface of the sacral prominence (sacral promontory) and the posterior surface (inferior margin) of the symphysis pubis measured by internal examination; AP diameter OBSTETRIC CONJUGATE= > 10 cm It is the distance between the midpoint of the sacral promontory & the midline of the symphysis pubis which is ascertained by subtracting 1 to 1.5 cm from the diagonal conjugate OC= DC – 1 to 1.5 TRUE CONJUGATE/CONJUGATA VERA= > 11 cm. It is the distance between the midpoint of the sacral promontory and the upper or superior margin of the symphysis pubis TUBERO-ISCHIAL or BI-ISCHIAL Diameter of the Outlet It is the distance between the ischial tuberosities, or the transverse diameter of the outlet (the narrowest diameter at that level, ot the one most apt to cause a misfit) It is made at the medial and lowermost aspect of the ischial tuberosities, at the level of the anus Diameter of 11 cm is considered adequate because it will allow the widest diameter of the fetal head, or 9 cm, to pass freely through the outlet