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STAGES OF LABOR:
#labour #obstetrics
Conventionally, events of labor are divided into three stages: First stage: It starts from the onset of true labor pain and ends with full dilatation of the cervix. It is, in other words, the “cervical stage” of labor. Its average duration is 12 hours in primigravidae and 6 hours in multiparae. Second stage: It starts from the full dilatation of the cervix (not from the rupture of the membranes) and ends with expulsion of the fetus from the birth canal. It has got two phases—(1) The propulsive phase—starts from full dilatation up to the descent of the presenting part to the pelvic floor. (2) The expulsive phase is distinguished by maternal bearing down efforts and ends with delivery of the baby. Its average duration is 2 hours in primigravidae and 30 minutes in multiparae. Third stage: It begins after expulsion of the fetus and ends with expulsion of the placenta and membranes (afterbirths). Its average duration is about 15 minutes in both primigravidae and multiparae. The duration is, however, reduced to 5 minutes in active management. Fourth stage: It is the stage of observation for at least 1 hour after expulsion of the afterbirths. During this period maternal vitals, uterine retraction and any vaginal bleeding are monitored. Baby is examined. These are done to ensure that both the mother and baby are well.
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owner: nerdparty67 - (no access) - Hiralal Konar - DC Dutta's Textbook of Obstetrics_ Including Perinatology and Contraception-JP Medical Pub. (2016).pdf, p160


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