embryology birth Flashcards
definition of a normal birth
- the baby is born after a period of pregnancy of 259-293 days
- labour has a duration between 3 and 18 hours
- the baby is born with its head in face-up position rotating to face-down position
- the amniotic sac breaks during the contractions
- blood loss of the mother is no more than 500ml
- mother and baby are not considerably endangered
Signs for an approaching delivery
- periodic contractions (intervals < 10 min.)
- loss of amniotic fluid
- vaginal bleeding
Trigger for contractions
Trigger: Protein
origin: in the lungs of the baby
=>
Trigger: release of hormone oxytocin
Origin: placenta
=>
Initiation of birth
hormone oxytocin
responsible for loyality to your partner, makes us feel physically connected to each other
breastfeeding mother & child
oxytocin = high (-> chance of cheating is lower)
First stage
- Contractions
Duration: 15-20h
Wehen= muscle contractions of the uterine muscle
After each contraction the musclefibres of the uterus do not fully return to their original length, but stay a bit shortened. -> The uterus wall is pulled over the head of the baby
Result of this process: cervix opened up to a max of 10cm
- Stage
- Descent and delivery of the infant
Duration: several minutes up to one hour
- this stage begins when the cevix is fully dilated
- Distance between p and s: 11cm
- Hormonal influence leads to: softening of the public bone
- Coccyx: Can be moved 2cm
- The baby is pressed from the uterine and abdomal muscle out of the birth canal head first; pressure may reach a level of 20 kPa
- When passing the birth canal, the child is performing a helical rotation into a face-down position.
coccyx
Steissbein
can be moved for 2cm
Where to deliver a baby
- at home (with midwife)
- delivery room
How to deliver
- lying on the back (supine)
- in the water
- standing
- Stage
- Delivery of the placenta
Duration: 15 min up to one hour…
-> until the placenta is completely delivered
After delivery: mother is to be observed for another 2h
=> the process of labour is now offically finished
Complications of birth:
Position
Longitudinal position (99,5%): Normal delivery
Transverse position (0,5%): Vaginal delivery is not possible
Complications of birth:
Size of birth canal
The canal’s diameter is too small for the cranum of the baby. Vaginal delivery will not be possible.
Complications of birth:
Umbilical cord prolapse (0,14-0,62%)
The fetus moves downward into the pelvis and puts pressure on the cord.. As a result, oxygen and blood supplies to the fetus are diminished or cut-off and the baby must be delivered quickly.
Immediate consequence: lock of oxygen
Lasting effects on the child: brain damage
Complications of birth:
placental abruption (1%)
Placental lining has separated from the uterus of the mother too early
Lasting effects on the child: lack of O2 -> brain damage
Lasting effects on the mother: loss of blood, severe case of shock (can cause death)
Solutions for a successful birth in case of complications:
1
- episiotomy (Dammschnitt)
This procedure is necessary when the tissue of the perinaeum cannot expand enough for the head of the baby to pass through without rupture
Solutions for a successful birth in case of complications
2
- Caesarean section
This procedure is the safest way of birth when a vaginal birth is risky or impossible. In Switzerland 15-20% of all babys are delivered this way.
Where and how is the section made?
Nowdays: Transverse cut just above the edge of the genital hair
PCA
patient controlled analgesia
(the more it is used the more the woman’s body is getting used to it)
DDA
peridural analgesia
