True Labor

Rest/activity Discomforts Contraction

False Labor Irregular No change in frequency, duration and intensity (Braxton Hicks Contraction) Pain at abdomen

Regular Increasing frequency, duration and intensity Shortening Interval Radiates from the back around the abdomen Contraction does not decrease with rest or activity/walking Progressive effacement and dilatation of cervix

Contraction may lessen with activity or rest Cervical changes do not occur yet

Cervix

escent of fetus into pelvic inlet LIGHTENING engagement of presenting fetal part at station or below

in Primi 2 weeks prior in Multi at onset of labor

pening cervical OS - DILATATION

oftening of the cervix

ontraction of uterus that are progressive and regular

upture of membrane ( ROM ) ffacement progressive thinning and shortening of cervix

pprehension
ucus plug expulsion BLOODY SHOW

STAGE 1 : Cervical Stage

PHASE DILATATI DURATION/INT ON ERVAL INTENSITY

Latent

0-3 cm

20 40 sec, 530 min

Mild to moderate

Active

4-7cm

40 60 sec, 3- Moderate to 5 min strong 60 90 sec, 23 min Strong

Transition

8-10cm

A. Natural Spontaneous Delivery (NSD)

Forceps

Vacuum Delivery

C. Caesarean Delivery (CS)

resentation

resentation

osition

tation

Plateau Stage

2. Factors that affects the mortality

b. Racial differences non-white have higher mortality than whites

c. Economic level poorest families have the highest mortality rate

d. Birth weight and gestation period the lesser the birth weight, the shorter gestation period the higher mortality

e. Birth order increasing order has higher mortality

birth

A.Size

A.Size Physical Growth

Height Weight

increases by: 12 months 50 % 4years old 2x

6 months 2x 12 months - 3x 30 months - 4x

b. Economic status infants from poorer districts are slightly smaller than from better districts

And Negro infants are smaller than white infants

c. Ordinal position - first born infant are on the average, smaller than later born

d. Fetal activity when excessive, this may cause the infant to be considerably underweight for his body length

B. Physical Proportions
a. Infants head is one-fourth of the entire body length. b. In the infant, the ratio between the cranium and the face is 8:1 c. The infants face is broad and short because of lack of teeth, the underdeveloped condition of the jaws, and the flatness of the nose.

d. The arms, legs and trunk are smaller in relation to the head.

e. The abdominal region of the trunk is larger and bulging, while the shoulders are narrow.

C. Infantile Features
a. The eyes are bluish gray but change gradually to whatever the permanent color will be.

b. Tear glands are inactive so crying is not accompanied by tears.

c. The neck is short and the skin has deep folds.

d. Muscles and bones are soft, small and uncontrolled.

e. Flesh in firm and elastic, while the skin is soft and deep pink in color.
f. Sometimes a soft growth of hair is found on the body, mostly on the back, but it soon disappears.

g. Once in every 2,000 births, the infant is born with one or two teeth.

Findings
Sole Creases

<37 wks Preterm

1/3 creases

37-42 wks Term

2/3 creases

>42 wks Post term

3/3 creases

Breast nodule diameter

Scalp hair Ear lobe

< 3 mm
Fine and fuzzy No cartilage

3 5 mm
course and silky Slight cartilage

> 5 mm
course and silky Thick cartilage

Testes and scrotum

Labia majora and minora

Testes in upper canal : few ruggae

Testes down : poor ruggae

Pendulous : extensive ruggae

l. Majora over the L. minora

L. Majora is in line with L. L. Majora more prominent minora