Page 47 - 2023 Elctronic Book (3) Normal Labor_Neat
P. 47

▪  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

                may be apprehensive about it, particularly if this is her first infant.
                •The nurse should ask the woman about her Maternal Health Card, show her the
                labor room, and help her undress and get into bed.

                •Admission should be carried out as quickly as possible.
            Assessment


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