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In medical terminology labor nothing but a
series of events that take place in the genital
organs in an effort to expect the viable product of
conception out of the womb through vaginal into the
outer world.
Sometimes it may occur prior to 37 weeks completed
,when it is said to be "preterm labor". In medical term
a "parturient " is a patient in labor and
parturition is process of giving birth.
According medical terminology delivery is the expulsion or extraction of a viable
fetus out of the womb. It is not synonymous with
labor, delivery can take place with out labor as an
in elective "caesarean section". Delivery may be
vaginal, either spontaneous or aided or it may be
abdominal.
What is labor ? and reason
or Cause of labor :
Normal Delivery:-
Labor is called normal if it fulfils the following
the following criteria:
1.Spontaneous in onset and at term
2.with vertex presentation
3.without undue prolongation
4.Without having any complication affecting the
health of the mother and or the baby.
The precise mechanism of initiation of labor still
obscure. Advancement of chemicohormonal technology
and inferences obtained from animal experiment
however, put forth the following hypotheses
a) Uterine distension:
Stretching effect on the myometrium by the growing
size of the fetus and liquor amnii can explain the
onset of labor at least in twist.
b) Feto-placental contribution:
It has been postulated that due to unknown factors,
fetal pituitary is stimulated prior to onset of
labor -->increased release of ACTH -->stimulates
fetal adnunals -->increase cortisol secretion
-->accelerated production of oestrogen &
prostraglandins from the placenta.
What is
False Pain?
False pain mostly found in first pregnancy than in
parous women. It is usually appear prior to
the onset of labor pain or by one or two week .The
women feel pain or discomfort in the abdomen and
these are mistaken for labor pain.
False pain has got following features:
1. Dull in nature & usually confined to the lower
abdominal & groin
2. Continuous & unrelated with hardening of the
uterus
3. Without any effect on dilatation of the cervix
4. Usually relieved by enema
Such pains are probably due to stretching of the
cervix and lower uterine segment with consequent
irritation of neighbouring ganglia.It may also
result from the lower segment & cervix resisting
unduly the "taking up" process which precedes the
onset of true labor. It is not only distressing
feature to the woman but also annoying to the
relatives & the obstetrician.
Pre-Labor:
the pre-monitory stage may being two or three week
before the onset of labor in first pregnancy a
few days before a multiparal. Few week prior to the
labor specially in first pregnancy, the presenting
part sinks the true pelvis. It is due to lower pole
of uterus .It signifies incorporation of the lower
uterus segment into the wall of the uterus. It may
be gradual process or may be felt abruptly. The
mother experience a sense of relief from mechanical
cardio-respiratory embarrassment. There may be
constipation due to mechanical factor pressure by
the engaged presenting part.
True labor pain:
The feature of true labor pain are
----- Painful uterine contraction (labor pain)
----- Progressive effacement and dilation of cervix
------ Formation of the "bag of water"
Through out the pregnancy ,painless braxten hicks
contraction with simultaneous hardening of the
uterus occur. These contraction change their
character become more powerful, intermittent and are
associated with pain. The pains are more often felt
in front of abdominal or radiating towards the
thighs.
When labor start, there is profuse cervical
secretion. Simultaneously, there is slight oozing of
blood from rupture of capillary vessels of the
cervix and from the raw decidual surface caused by
separation of the membranes due to stretching of the
lower uterine segments. When labor pain start
cervical canal begins to dilate more in the upper
part than lower part, the former being accompanied
by corresponding stretching of the lower uterine
segment.
Due to stretching of the uterine segment ,the
membranes are detached easily because of its loose
attachment to the poorly form deciduas. With the
dilation of the cervical canal, lower pole of the
fetal membranes become unsupported & tends to bulge
into the cervical canal. As it contain liquor which
has passed below the presenting part, it is called
"bag of water". During uterine contraction with
consequent rise of intra-amniatic pressure ,this bag
become tense & convex. After the contraction pass
off, the bulging may disappear completely. This is
almost a certain sign of labor.
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