Medicine an Surgery notes

Apr 24th, 2015
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PartogramAssessing cervical dilatationChanges induced in the cervixLatent phase :p <20hrs , M < 14hrsActive : P 1.2 cm/hr, M 1.5cmlatent phase cervix undergoes softening andeffacement but slight dilatationUterine contractions are of mild intensity, shortduration & variable frequencyHydrostatic pressure through the membrane orthe presenting part against the cervix &loweruterine segment effacement and dilatation topreviously ripe cervixCervical dilatationCx ripening is under hormonal control Progesterone inhibits or delays RU 486 ripens cx E & Relaxin promotes ripening Cx changes Decrease in cx collagen cxbecomes softer distensible > cx shortening( effacement ) & endocervical canalwidens( dilatation)Mechanism of cx dilatationCx dilatation of 10 cm for the fetal delivery tooccurLower uterine segment & cervix are regions oflow resistantContraction > centrifugal pull and distensionContraction- pressure on the membranes,hydrostatic action of the amniotic sac, in turnsdilates the cervical canal in the middle of wedgeCx asessmentDilatation Effacement Consistency Position Station Every 4 hrs ( if need arises every 2 hrs)Mechanism of cx effacementEffacement obliteration or taking upShortening of the cx canal from 2 cm to <0.5cm takes place from up to downwards>showPatterns of the cx dilatationLatent little bearing on labour

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