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As the fetal hypothalamus matures, the activation of the hypothalamic–pituitary–adrenal (HPA) axis initiates labor through two hormonal mechanisms. The end pathway of both mechanisms lead to contractions in the myometrium, a mechanical cause of placental separation, which is due to the sheer force and contractile and involutive changes that occur within the uterus, distorting the placentome.
It will contract midline with the umbilicus. It begins its contractions and by twelve hours after the birth it can be felt to be at the level of the umbilicus. [9] The uterus changes in size from one kilogram to 60-80 grams in the space of six weeks. After birth, the fundus contracts downward into the pelvis one centimeter each day.
The latent phase is defined by cervical dilation of 0 to 6 cm. The active phase is defined by cervical dilation of 6 cm to 10 cm. Second stage of labor starts when the cervix is dilated to 10 cm and finishes with the birth of the baby. This stage is characterized by strong contractions and active pushing by the mother.
When the presenting part is at the ischial spines the station is 0 (synonymous with engagement). If the presenting fetal part is above the spines, the distance is measured and described as minus stations, which range from −1 to −4 cm. If the presenting part is below the ischial spines, the distance is stated as plus stations ( +1 to +4 cm).
Mother with newborn baby. The postpartum (or postnatal) period begins after childbirth and is typically considered to last for six weeks. [1] There are three distinct phases of the postnatal period; the acute phase, lasting for six to twelve hours after birth; the subacute phase, lasting six weeks; and the delayed phase, lasting up to six months.
Cervical dilation may be induced mechanically by placing devices inside the cervix that will expand while in place. A balloon catheter may be used. Other products include osmotic dilators , such as laminaria stick (made of dried seaweed) or synthetic hygroscopic materials, which expand when placed in a moist environment.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.
[35] [36] The second phase of labor begins when the cervix has dilated to 10 cm (4 in), which is regarded as its fullest dilation, [31] and is when active pushing and contractions push the baby along the birth canal leading to the birth of the baby. [34]