CERVICAL CHANGES Click to edit Master subtitle style DURING FIRST TWO FUNDAMENTAL STAGE LABOR CHANGES:

Result from contraction forces that takes place in the already ripened cervix.
A.

EFFACEMENT B. DILATATION
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10 cm. approximate diameter of the cervical canal needed for an average-sized fetal head can pass through - the cervix is said to be completely or fully dilated

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CERVICAL EFFACEMENT

Obliteration or Taking up of the cervix Shortening of the cervical canal from 2cm to a mere circular orifice with almost paper-thin edges. Due to increased myometrial activity during uterine preparation for labor
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CERVICAL EFFACEMENT

Appreciable effacement of a softened cervix is sometimes accomplished before active labor begins. Interal cervical os: muscle fibers at this level are pulled upward or taken up into the lower uterine segment. External os: temporarily unchanged 5/22/12

CERVICAL DILATATION
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A centrifugal pull exerted on the cervix leading to distension because the lower uterine segment and cervix have lesser resistance during a contraction. As uterine contractions cause pressure on the membranes, hydrostatic action of the amniotic sac dilates cervical canal like a wedge.
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CERVICAL DILATATION

Cervical Effacement and Dilatation Causes formation of

forebag of amniotic fluid (located in front of the presenting part)

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CERVICAL DILATATION
A. B.

Divided into 2 phases: Latent Phase Active Phase 1. Acceleration Phase 2. Phase of Maximum Slope 3. Deceleration Phase
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CERVICAL DILATATION
Latent Phase
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Has little bearing on the subsequent course of labor Duration is more variable and sensitive to changes by extraneous factors
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Sedation prolongs duration Myometrial Stimulation shortens duration

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CERVICAL DILATATION
Acceleration Phase
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Usually predictive of a particular labor outcome

- First stage of labor ends when cervical dilatation is complete during the active phase
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SECOND STAGE OF LABOR: FETAL DESCENT

Station - Describes descent of fetal biparietal diameter in relation to a line drawn between the maternal ischial spine.

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SECOND STAGE OF LABOR: FETAL DESCENT Negative numbers

1.

during labor: -. baby's head is above the ischial spines . -. For example -1 means baby's head is 1 centimeters above the ischial spines. -. Negative numbers above -3 means fetal head is unengaged or floating. 2. Positive numbers during labor: 5/22/12 baby's head is below the

PELVIC FLOOR
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PELVIC FLOOR CHANGES DURING LABOR

Supports the birth canal Functionally closed by several layers of tissues

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PELVIC FLOOR CHANGES DURING PELVIC FLOOR LABOR

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Most important structures: 1. Levator ani muscles and their fibromuscular connective tissues - covers upper and lower surfaces 2. Piriformis and Coccygeus muscles 5/22/12

PELVIC FLOOR CHANGES DURING LABOR

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PELVIC FLOOR CHANGES DURING LABOR LEVATOR ANI MUSCLES

Consists of: a. Pubovisceral mm. b. Puborectalis mm. c. Iliococcygeal mm. -. Varies thickness from 3-5mm -. Margins encircling rectum and vagina are somewhat thicker -. During pregnancy: undergoes hypertrophy -. On contraction: draws both rectum and vagina forward and upward in the direction of the symphisis pubis 5/22/12 -. First Stage of Labor: stretching of