Page 176 - كتاب تمريض نسا الاكتروني

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The first stage of labor can be divided into two phases:

1- Latent phase: ( initial slow phase)
▪ The cervical dilatation from 0-3 cm.
▪ Contraction duration 20-40seconds.
▪ Contraction intensity mild by palpation.
The uterine contractions are somewhat uncomfortable, but generate force to
cause slow dilatation and some effacement of the cervix.A prolonged latent phase
is greater than 20 hours in the primigravida &14 hours in multipara.
2- Active Phase: (Rapid Phase)
▪ The cervix dilates from 4-7cm.
▪ Characterized by progressive cervical dilation.
▪ Contraction duration 40-60 seconds.
▪ Contraction intensity moderate by palpation.
▪ A prolonged active phase is seen in the primigravida who dilates at less than 1.2
cm/hr. & in the multigravida at less than 1.5 cm/hr.
3-Transitional Phase:
▪ The cervix dilates from 8-10 cm.
▪ Contraction duration 60-90 seconds occurring every 2 -3 minute.
▪ Contraction intensity strong by palpation.

Note:

Active Latent phases of Labor: Normally the cervix dilates slowly to reach 3-4 cm
(latent phase) and then rapidly to reach 9 cm (active phase) and then slowly to full
dilatation (sigmoid curve). A latent phase is considered prolonged if it lasts more than

20 hours in the primigravida and more than 14 hours in the multigravida. During the
active phase, the primigravida usually dilates 1 cm per hour and a multiparous patient
dilates 1.5 cm per hour

Nursing Management of First Stage of Labor
Admission of the Woman

•The nurse should welcome and greet the woman in a kind way. This wi1l be
important in the future relationship. It may be her first admission to hospital, and she

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