Management of labor

Management of labor...
 Childbirth also known as labour or delivery,is the ending of prgenency where are or more babies leaves the uterus by passing through the vagina or by caesarean section
First stage of labour-
Phycological and emotional support
Fear of danger
Fear of pain
Maximum supervision and minimum action
Bladder and Bowes care
Fatal heart rate check in every 30 minute (second stage within 15minute)
Position-membrane infact than Ambulate
  Membrane ruptured than Left to latter position, and alow to sleep
Pain .... Injection Morphine 10mg IM
  Second stage of labour
 First of all 
Position -Lithotomy
FHR-In every 15minute
Encarage the mother to bearing down effort with each contraction
Third stage of labour
Examine the placenta
One placenta= 15 -29 Cotyledons
Count the cotyledons 
Retaine placenta =secondary PPH 
PPH=Post partum haemorrhage
Assement of placenta
   Suddenly increase the length of out side umblical cord
Suddenly expall in large amount of blood
Third stage management are two types
First  -Expected management
Second- Active management
Expected management - after sapration of placenta 
5 /10IU oxytocin IM
Wait 5 to 10 minutes
Control cord traction expall out
Active management-if placenta not separate
10 IU Oxytocin IM
Wait 
Fail
Manul remove under the general
Anesthesia 
Thiopental sodium 4 to 5mg/kg

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Third Complications of labor

चित्र
All women who deliver are at risk of complications in third stage of labor.These complications include Post partum Hemorrahege Retention of placenta (Retained placenta) Inversion of uterus Plumonary embolism Obsteric shock Injurier of birth canal     Retained placenta Management 1) Fundal pressure 2) Controll word traction 3) Manual remove of placenta under Genearl Anesthesia 1) Fundal pressure After seperation of placenta Pressure=Dounword and backward pressure on funda part and pull out the umblical word 2) Controll card traction  placenta separate Pressure on symphysis punia upword and backward Pull out with umblical word 3) Manual remove of placenta under general anesthesia Placent not seperat Female=General Anesthesia (Thiopentel sodiyam 4 to 5 mg/kg) Wear the gloves and insert hand in cone shape manner And reach hoti placenta margin Slicing movemen
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Anatomy and physiology of Vagina to prevent infection

चित्र
In adult female ,vagina is lined by stratified squamous epithelium.In newborn female,it is lined by transitional epithelium.squamous epithelium is resistant to gonococcal infection.Thus , gonococal vaginitis cannot occur in adult female. Vagina has local inhabitant bacteria called Doderlein's bacillus Which breaks down the glycogen present in vaginal epithelium into lactic acid resulting in acidic pH(4-5.5, average 4.5) of vagina.The acidic pH of vagina acts as a barrier for external organism and protect from infection. Physiological vaginal discharge..... Clear, white and flocculent odourless discharge. Smear contains epithelial cells, lactobacillus pH ranges from 3.8 to 4.2 pH increase with increased oestrogen States:in pregnancy,OCP,mid-cycle,PCOS or premenarchal If pH increase in primenopausal woman, investigation for other effects of excess oestrogen. This area is subject to both primary and secondary infection.Ascending infection can occur from the vagina and c
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Antepartum Heamorrhage APH

चित्र
Antepartum haemorrhage APH APH is usually define as bleeding form the birth canal after the 24 to 28 weeks of  pregnancy.It can occur at any time until the second stage of lobour is complete; bleeding following the birth of the baby is postpartum haemorrhage=Miscarriage Or  Any ammount of bleeding from genital tract after 28 weeks to before of bleeding 28wk ..... Delivery time....6wk APH_________IPH_________PPH ETIOLOGY  --- Idiopathic/unknown 2types    1) Placenta previa (pp) 2) Abrupto previa (AP) Placenta previa=in lower uterin segement Implantation posterior wall of bady of uterus near the fundus Abrupto precisa=premature separation of placenta Most common risk of APH Dropping down theory= Drop down in lower uterine segments Implantation Due to less endometrial reactions Increase that cilliary active of fallopian tube A)Types of placenta previa 1)Types 1 (PP)  low lying place
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