,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Normal Labor and Delivery,正 常 分 娩,Obs&Gyn Department of 1st Clinical Hospital,Wuhan University,Associate Professor Ming lei,（明蕾）,Normal Labor and Delivery正 常,1,影响分娩的四大因素2FourfactorsforlaborFetusNormalLaborand课件,2,Outline,Definition,1,2,3,Mechanism of labor,Four factors for labor,2,3,（定义）,OutlineDefinition123Mechanism,3,Definition,1,Delivery,is the process by which the mature or nearly mature fetus and placenta,are expelled from the maternal body after 28 weeks,分娩是指妊娠满,28,周及以后的胎儿及其附属物从母体排出的过程,（定义）,Definition1Delivery is the pro,4,Definition,1,Term delivery:,37-42,weeks,1,足月产,Pre-term delivery:,28-37,weeks,2,早 产,Post-term delivery:,42,weeks,3,过期产,Abortion:,4,流 产,28,weeks,（定义）,Definition1Term delivery:,5,Definition,1,3,Mechanism of labor,2,Four factors for labor,Outline,影响分娩的四大因素,Normal Labor and delivery,Force,Birth,canal,Fetus,Psychical,factors,产 力,产 道,胎 儿,精神因素,Definition13Mechanism of labor,6,影响分娩的四大因素,2,Four factors for labor,Force,Expulsive,Force,产力,Intra,abdominal,pressure,This is created by contraction of the abdominal muscles simutaneously with forced respiratory efforts with the glottis close.this is referred to as pushing,Levator,ani muscle,Levator ani muscle is the most important part of pelvic floor,Ancillary,Force,辅助产力,uterine,contraction,A rhythmic tightening in labor of the upper uterine musculature that contracts the size of the uterus and pushes the fetus toward the birth canal,Major force,子 宫,收缩力,影响分娩的四大因素2Four factors for lab,7,Rhythm,节律性,Symmetry,对称性,Polarity,极 性,Retraction,缩复性,intermission,Contraction,contraction,影响分娩的四大因素,2,Four factors for labor,uterine,Contraction,feature,Force,子宫收缩力的四大特征,Rhythm 节律性Symmetry 对称性Pola,8,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Normal Labor and delivery,Force,Fetus,Psychical,factors,产 力,产 道,胎 儿,精神因素,影响分娩的四大因素2Four factors for lab,9,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Bony canal,骨产道,Birth canal,产道,Soft tissue canal,软产道,重点,影响分娩的四大因素2Four factors for lab,10,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Bony canal,骨产道,Pelvic inlet plane,Superior strait,Pelvic outlet plane,Inferior strait,Midpelvis outlet,least pelvic dimension,plane,pelvic axis,(,骨盆轴,),:,A hypothetical line curving through,the midpoint of the pelvic planes,连接骨盆各平面中点的假想曲线,影响分娩的四大因素2Four factors for lab,11,影响分娩的四大因素2FourfactorsforlaborFetusNormalLaborand课件,12,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Soft canal,软产道（重点）,Lower uterine segment,子宫下段,Cervix,floor of pelvis,vagina,宫颈、阴道、会阴及盆底,Soft tissue part canal,软产道,影响分娩的四大因素2Four factors for lab,13,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Soft canal,软产道,formation of lower uterine segment,子宫下段形成,非孕时子宫 孕足月子宫 第一产程子宫,子宫峡部,isthmus,影响分娩的四大因素2Four factors for lab,14,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Soft canal,软产道,cervical effacement and dilatation,宫颈管消失及宫口扩张,宫颈管,影响分娩的四大因素2Four factors for lab,15,Soft canal,软产道,影响分娩的四大因素,2,Four factors for labor,Birth,canal,Soft canal影响分娩的四大因素2Four facto,16,影响分娩的四大因素,2,Four factors for labor,Fetus,Normal Labor and delivery,Force,Birth,canal,Psychical,factors,产 力,产 道,胎 儿,精神因素,Fetus,胎儿,Fetal size,胎儿大小,Fetal lie,胎产式,Fetal attitude,胎姿势,Fetal station,胎先露高低,Fetal presentation,胎先露,Fetal position,胎方位,影响分娩的四大因素2Four factors for lab,17,影响分娩的四大因素,2,Four factors for labor,Fetus,Fetal lie,胎产式,：,胎体纵轴与母体纵轴的关系,Relation of long axis of fetus to that of the mother.Longitudinal,纵产式,(99%),transverse,横产式,or oblique,影响分娩的四大因素2Four factors for lab,18,影响分娩的四大因素,2,Four factors for labor,Fetus,Fetal presentation,胎先露,：,最先进入骨盆入 口的胎儿部分,Fetal part that directly overlies pelvic inlet,Cephalic,头先露,breech,臀先露,or shoulder,肩先露,影响分娩的四大因素2Four factors for lab,19,影响分娩的四大因素,2,Four factors for labor,Fetus,Fetal position,胎方位,：,胎儿先露部指示点与母体骨盆的关系,（难点）,The relation of an arbitrarily,chosen portion of the presenting part of the fetus to the right or left side of the maternal birth canal.,For more accurately,anterior,transverse,posterior,影响分娩的四大因素2Four factors for lab,20,影响分娩的四大因素,2,Four factors for labor,Fetus,LOA(left occipito-anterior),ROA(right occipito-anterior),枕左前位,枕右前位,头先露指示点,枕骨,影响分娩的四大因素2Four factors for lab,21,影响分娩的四大因素,2,Four factors for labor,Fetus,LOT(left occipito-transverse),ROT(right occipito-transverse),枕左横位 枕右横位,影响分娩的四大因素2Four factors for lab,22,影响分娩的四大因素,2,Four factors for labor,Fetus,LOP(left occipito-posterior),ROP(right occipito-posterior),枕左后位 枕右后位,影响分娩的四大因素2Four factors for lab,23,影响分娩的四大因素,2,Four factors for labor,Fetus,影响分娩的四大因素2Four factors for lab,24,影响分娩的四大因素,2,Four factors for labor,Fetus,LOA,left occipito-anterior,(,枕左前位,),影响分娩的四大因素2Four factors for lab,25,Outline,Definition,1,3,Mechanism of labor,2,Four factors for labor,Occiput presentation,(,枕先露的分娩机转,),重难点,1,engagement,衔 接,2,descent,下 降,3,flexion,俯 屈,4,internal rotation,内 旋 转,5,extension,仰 伸,6,external rotation,外 旋 转,7.,expulsion,娩出,OutlineDefinition13Mechanism o,26,Mechanism of labor,(,枕先露的分娩机转,),Occiput presentation,3,Mechanism of labor(枕先露的分娩机转)Oc,27,Mechanism of labor,(,枕先露的分娩机转,),Occiput presen