The second stage begins with the complete dilatation of the cervix and ends with
the expulsion of the fetus. This stage is concerned with
a) The descent
b) Delivery of the fetus through the birth canal
The descent -
Descent of the fetal presenting part, which begin during the first stage of labour and
reached its maximum speed towards the end of the first stage, continuous its rapid
pace through the second stage of labour. The average maximum rate of descent is
1.6 cm/hour in nullipara and 5.4 cm/hour in multipara.
Delivery of the fetus through the birth canal -
With the full dilatation of the cervix, the membranes usually rupture and there is escape
of good amount of liquor amnii. The volume of the uterine cavity is thereby reduced.
Simultaneously, uterine contraction and retraction become stronger.
Delivery of the fetus is accomplished by the downward thrust offered by
uterine contractions supplemented by voluntary contraction of abdominal muscles against
the resistance offered by bony and soft tissue of the birth canal. Endowed with power of
retraction, the fetus is gradually expelled from the uterus against the resistance offered by
the pelvic floor.
The expulsive force of uterine contractions is added by voluntary contraction
of the abdominal muscles called ''bearing down'' efforts.
Que. - What is bearing down efforts ?
Ans. - It is an additional voluntary expulsive efforts that appear during the second stage
of labour (expulsive phage). It is initiated by nerve reflex set up due to stretching of
the vagina by the presenting part. In majority, this expulsive effort start spontaneously
with the full dialatation of the cervix. Along with uterine contraction, the woman, the
woman is instructed to exert downward pressure as done during straining at stool.
There may be slowing of the FHR during pushing and it should come back to normal
once the contraction is over.
the expulsion of the fetus. This stage is concerned with
a) The descent
b) Delivery of the fetus through the birth canal
The descent -
Descent of the fetal presenting part, which begin during the first stage of labour and
reached its maximum speed towards the end of the first stage, continuous its rapid
pace through the second stage of labour. The average maximum rate of descent is
1.6 cm/hour in nullipara and 5.4 cm/hour in multipara.
Delivery of the fetus through the birth canal -
With the full dilatation of the cervix, the membranes usually rupture and there is escape
of good amount of liquor amnii. The volume of the uterine cavity is thereby reduced.
Simultaneously, uterine contraction and retraction become stronger.
Delivery of the fetus is accomplished by the downward thrust offered by
uterine contractions supplemented by voluntary contraction of abdominal muscles against
the resistance offered by bony and soft tissue of the birth canal. Endowed with power of
retraction, the fetus is gradually expelled from the uterus against the resistance offered by
the pelvic floor.
The expulsive force of uterine contractions is added by voluntary contraction
of the abdominal muscles called ''bearing down'' efforts.
Que. - What is bearing down efforts ?
Ans. - It is an additional voluntary expulsive efforts that appear during the second stage
of labour (expulsive phage). It is initiated by nerve reflex set up due to stretching of
the vagina by the presenting part. In majority, this expulsive effort start spontaneously
with the full dialatation of the cervix. Along with uterine contraction, the woman, the
woman is instructed to exert downward pressure as done during straining at stool.
There may be slowing of the FHR during pushing and it should come back to normal
once the contraction is over.
No comments:
Post a Comment