Page 58 - 33Elctronic Book (3) Normal Labor

▪ A fetal heart rate increasing to more than 160 b/min, or decreasing to less than

100 b/m, or becoming irregular.
▪ Passage of meconium in cephalic presentation.
Complications:
o Powers: Hypotonic or hypertonic uterine action. Passengers: Big infant,

malposition, and malpresentation.
o Passages: CPD/ fetopelvic disproportion (Contracted pelvis), and rigid cervix.
Evaluation (Expected Outcomes)

• The woman progresses normally.
• She experiences increased comfort.

• The fetal heart rate remains within normal limits.
• The woman's hydration remains with normal limits.

▪ Second Stage (expulsion of the fetus)
Definition:
It begins with the fully dilatation of the cervix, and ends with delivery of the fetus. It

takes about one hour in the primigravida and half hour in the multigravida

Criteria of the Second Stage of Labor

1- The patient starts to bear down during uterine contractions due to pressure of the

presenting part on the rectum and pelvic floor causing reflex involuntary contraction
of the diaphragm and abdominal muscles.

2- The patient fells the desire to evacuate the rectum or bladder.

3- Rupture of the membranes and flow of the amniotic fluid. Normally this occurs when
the cervix is fully dilated, however, it may occur early in labor in the first stage or
even before the start of labor( premature rupture of membranes). It may not occur at

all and the fetus is delivered inside the intact amniotic sac.

1- Full dilatation of the cervix: When it is fully dilated, it is 4 inches or 10cm. in
diameter and can admit 5 fingers (this is the sure sign).

❖ The Mechanism of Normal Labor:

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