Page 45 - 2023 Elctronic Book (3) Normal Labor_Neat

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 amnioti c 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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