SKILLS LAB

Maternal and child

FIRST MANEUVER
NORMAL FINDINGS
SECOND MANEUVER
NORMAL FINDINGS
THIRD MANEUVER
NORMAL FINDINGS
FOURTH MANEUVER
NORMAL FINDINGS
MOVIE CLIP OF LEOPOLD’S
MANEUVER
 CARDINAL SIGNS OFF LABOR /
MECHANISMS OF LABAOR
 ENGAGEMENT
 DESCENT
 FLEXION
 INTERNAL ROTATION
 EXTENSION
 EXTERNAL ROTATION
 EXPULSION
 (ED FIRE ERE)
Cardinal / mechanisms of labor
 STAGES OF LABOR
STA
GE PHASE DILATA DURATION / INTENSITY
TION INTERVAL
1ST PHASE I : Latent 0-3 cm 20-40sec, 5- Mild to
ST PHASE II : 4-7 cm 30mins
40-60sec, 3-5mins Moderate
Moderate to
A Active Strong
GE PHASE III : 8-10 cm 60-90sec, 2-3mins Strong
Transition
PHASE STATIO CONTRACTION
2N PHASE I N
0 to +2 2 to 3 minutes apart
D
PHASE II +2 to +4 2 to 2.5 mins apart with urgency to
ST bear down
A PHASE III +4 to birth2 mins apart; fetal head visible
GE
RD increased
3 PLACENTA DELIVERY – Sudden gush of blood, lengthening of the cord, rising of
STAG
E the fundus, globular uetrus.
2 PHASES: 1. placental separation 2. placental expulsion
4th First 4 hours after delivery of the placenta
STAG
E *vital signs, fundus and lochia monitoring every 15 minutes until stable*
 NuRSING MANAGEMENT DURING
LABOR
 Vital signs and FHR
 Provide comfort measures ( ambulate and if BOW not yet ruptured ,
left side lying is the most comfortable position and provide sacral
pressures and back rubs)
 Note: left side lying position prevents vena cava syndrome
 Breathing technique during transition phase:
 Take a deep breath and exhale slowly and completely. At the
beginning of contraction, take a fairly deep breath. Then
engage is shallow breathing. If there is an urge to push, puff
out every 3rd , 4th , or 5th breath. Take a deep breath at the
end of contraction.
 Placental delivery may take 5 – 10 minutes ( maximum 20 minutes).
Either by Duncan (dirty presentation of the uterus) or schultze
( shiny glistening). Evaluate placental completeness( up to 30
cotyledons, weighing about 400 to 600 grams (1lb) and is 1/6 of the
fetal weight.
 Credes maneuver is gentle pressure on the contracted uterine fundus (
never on the non-contracted state or the uterus may evert and lead
to hemorrhage). Meanwhile, Brandth-Andrew maneuver is pushing
the uterus upward while gently pulling the cord downward to deliver