Page 174 - كتاب تمريض نسا الاكتروني
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            Signs of True Labor pains:
                      •  True uterine contractions are characterized as follows:

                    o      The uterus contracts and retracts.
                    o      Contractions occur at regular intervals or frequency
                    o      Interval between contractions gradually decreases.

                    o      The duration of contractions exceeds 90 seconds.
                    o      Intensity of contractions gradually increases.
                    o      Painful causing colicky pain in the lower part of the back and extend to

                    the abdomen.
                    o      Show is present.
                    o      Cervical dilatation is present.

                    o      Walking and enema intensify the discomfort.
                 •  Dilatation of the internal cervical Os:
                 A closed internal os means labor has not started; however,  the dilation of the

                 internal cervical Os from a small opening until it reaches 10 cm, to permit the
                 passage of the fetus. Dilatation is completed when the cervix cannot be felt

                 •  Show:
                  The  cervical plug that closed the cervical  canal  during pregnancy to prevent
                 infection descends during labor in the form of mucus stained with blood. The blood
                 flows due to  separation of the  membranes from  the lower uterine  segment  or

                 rupture of minute capillaries during separation of this plug from the cervical canal.
                 •  Formation of the bag of water:

                  When the cervix dilates, the lower part of the membranes detaches and bulges
                 through the dilating cervix. The trickle of amniotic fluid descends in the bulged part
                 of membranes, and is called fore water The remainder amniotic fluid is called          hind

                  . water


              Stages of Labor

            The process of labor is divided into four distinct stages:
                 •  First stage (stage of cervical dilatation): begins with the onset of true labour
                 pain and ends with fully dilatation of the cervix.




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