Page 45 - 33Elctronic Book (3) Normal Labor
P. 45

o  In multiparas, it is more likely to occur after labor begins and even

                               after the start of the second stage.
                            o  Relief of upper abdominal pressure symptoms (dyspnea Dyspepsia,
                               palpitation) due
                       to descent of the uterine fundus &due to shelving.

                            o  Signs  of  greater  lower  pressure  follow  this  relief  such  as  shooting
                               pains in the leg due to pressure on the sciatic nerve and an increase of
                               the vaginal discharge.


            3-Frequency of micturition:
             It occurs as a result of engagement. The pressure of the presenting part on the urinary

            bladder limits its capacity.
            4-Effacement of the cervix:
            Is  the  shortening  or  slight  taking  up  of  the  cervical  canal  from  structure  of

            approximately 2 cm in length to 1 cm

                ❖ Relationship of Maternal Pelvis and Presenting Part:

                ▪  Engagement of the presenting part occurs when the largest diameter of the

                    presenting part reaches or passes through the pelvic inlet. Engagement can

                    be  determined  by  vaginal  examination.  In  Primigravida  engagement

                    usually occurs 2 weeks before term. However, multiparas may experience

                    engagement several weeks before the onset of labor during the process of

                    labor. The presenting part is said to be floating or ballottable when it is

                    movable above the inlet.


















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