A low WCC especially with neutropenia is also suspicious of sepsis. CRP is most useful as a trend, rather than as a diagnostic marker.
The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix.
The contractions become progressively more rhythmic and stronger. This is followed by the active phase of labor, which usually begins at about cm of cervical dilation and is characterized by rapid cervical dilation and descent of the presenting fetal part.
The first stage of labor ends with complete cervical dilation at 10 cm. According to Friedman, the active phase is further divided into an acceleration phase, a phase of maximum slope, and a deceleration phase. Characteristics of the average cervical dilatation curve is known as the Friedman labor curve, and a series of definitions of labor protraction and arrest were subsequently established.
The AmericanCollege of Obstetricians and Gynecologists ACOG has suggested that a prolonged second stage of labor should be considered when the second stage of labor exceeds 3 hours if regional anesthesia is administered or 2 hours in the absence of regional anesthesia for nulliparas.
In multiparous women, such a diagnosis can be made if the second stage of labor exceeds 2 hours with regional anesthesia or 1 hour without it. Studies performed to examine perinatal outcomes associated with a prolonged second stage of labor revealed increased risks of operative deliveries and maternal morbidities but no differences in neonatal outcomes.
The third stage of labor is defined by the time period between the delivery of the fetus and the delivery of the placenta and fetal membranes. During this period, uterine contraction decreases basal blood flow, which results in thickening and reduction in the surface area of the myometrium underlying the placenta with subsequent detachment of the placenta.
Expectant management of the third stage of labor involves spontaneous delivery of the placenta. Although labor and delivery occurs in a continuous fashion, the cardinal movements are described as 7 discrete sequences, as discussed below. On the pelvic examination, the presenting part is at 0 station, or at the level of the maternal ischial spines.
The downward passage of the presenting part through the pelvis. This occurs intermittently with contractions.
The rate is greatest during the second stage of labor. Flexion As the fetal vertex descents, it encounters resistance from the bony pelvis or the soft tissues of the pelvic floor, resulting in passive flexion of the fetal occiput.
The chin is brought into contact with the fetal thorax, and the presenting diameter changes from occipitofrontal Internal rotation brings the AP diameter of the head in line with the AP diameter of the pelvic outlet. Extension With further descent and full flexion of the head, the base of the occiput comes in contact with the inferior margin of the pubic symphysis.
Upward resistance from the pelvic floor and the downward forces from the uterine contractions cause the occiput to extend and rotate around the symphysis. The anterior shoulder is then rotated under the symphysis, followed by the posterior shoulder and the rest of the fetus.
Clinical History and Physical Examination. Braxton-Hicks contractions, which are often irregular and do not increase in frequency with increasing intensity, must be differentiated from true contractions. Braxton-Hicks contractions often resolve with ambulation or a change in activity.
However, contractions that lead to labor tend to last longer and are more intense, leading to cervical change. True labor is defined as uterine contractions leading to cervical changes.Meconium aspiration syndrome (MAS) refers to breathing problems that a newborn baby may have when: There are no other causes, and; The baby has passed meconium (stool) into the amniotic fluid during labor or delivery; MAS may occur if the baby breathes in (aspirates) this fluid into the lungs.
Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan Imtiaz Jehan a, Hillary Harris b, Sohail Salat a, Amna Zeb a, Naushaba Mobeen a, Omrana Pasha a, Elizabeth M McClure b, Janet Moore b, Linda L Wright c & Robert L Goldenberg d.
a. Aga Khan University, Karachi, Pakistan. Oligohydramnios refers to a situation where the amniotic fluid volume is less than expected for gestational age. rupture of membrane and meconium stained liquor primigravida respondents whose duration of labour was Thesis Committee of Nursing Program, Chitwan Medical College (P) Ltd.
permitted this research. Objective To investigate the clinical significance of interleukin,12and tumor necrosis factor-α in idiopathic hypercholanaemia of plombier-nemours.coms70cases of pregnant women with GlycocholicAcid≥μmol/L, including40cases of dysfunction of liver (ICP group),30cases of normal liver function (19cases were asymptomaticgroup,11cases were symptomatic), and30cases of normal .
Several studies have shown an association between ethnicity and the prevalence of meconium stained amniotic fluid. In our study, this condition was an indication for referral in % of Dutch women and in % of non‐Dutch women (P. S. No. Plan of Thesis (Year ) 1.
Role of intrapartum oropharyngeal suctioning in neonates born through Meconium stained amniotic fluid in preventing Meconium aspiration syndrome Microsoft Word - 15 - Thesis Titles - PAEDIATRICS- and Author: Shabu James.