产程的观察与处理.pptx

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1、妇产科护理nursingofgynecologyandobstetreics正常分娩NormalLabor董丽媛DongLiyuan1.假临产即不规则的宫缩。FalseLabor–irregularuterinecontraction2.胎儿下降感因胎先露入盆即衔接所致。Feelingoffetaldescendingduetoengagementoffetalpresentation,whichisalsoknownasjointing.3.见红分娩前24～48h，阴道排出血性分泌物。Bloodysecretioncanbeseen24～48hbeforedelivery.先兆临

2、产Threateneddelivery1.规律性宫缩的出现。30秒以上/5～6分左右Irregularuterinecontraction:30secondsorlonger/5～6minutes2.宫颈管的消失。Cervicalcanalsdisappear3.宫口的扩张。Dilatationofcervicalorifice4.胎先露的下降。Descendingoffetalpresentation临产诊断DiagnosisBeforeDelivery一、评估病史evaluationofmedicalhistory1.确认产前检查资料Confirmthedataofprenat

3、alphysicalexamination.2.了解此次妊娠史Gettheinformationofthispregnancy.3.了解骨盆大小、胎先露、胎方位及胎心等。Gettheinformationofthesizeofpelvic,fetalpresentation,fetalposition,andfetalheartrate,etc.4.过去妊娠史Pregnancyhistory5.一般健康状况及家族史Generalhealthconditionandfamilyhistoryofpregnancy临产妇入院评Evaluationofadmissionforpartur

4、ients二.入院后身体评估physicalevaluation观察：生命体征Observation：vitalsigns了解:1.宫缩强度、宫口扩张、胎先露下降、破膜与否2.胎心率、胎方位、胎产式。gettingtheinformationof:1.uterinecontraction,dilatationofcervix,descendingoffetalpresentetion,ruptureoffetalmemberanes2.fetalheartrate,fetalposition,thewayofpresentation正确评估:产妇对疼痛的耐受性。evaluation

5、:toleranceofpain临产妇入院评Evaluationofadmissionforparturients总产程：规律宫缩---胎儿胎盘娩出Theoverallprocess:fromuterinecontractiontodeliveryoffetusandtheplacenta第一产程（ 宫颈扩张期）；从规则宫缩到宫口开全。Thefirststageofdelivery(dilatationofcervix):fromirregularcontractiontocompletedilatationofcervicalorifece.初产妇一般需要11～12h；经产妇约需

6、6～8h。generally11～12hforprimparaand6～8hformultipara第二产程（ 胎儿娩出期）：从宫口开全到胎儿娩出。Thesecondstageofdelivery(deliveryoffetus):fromcompletedilatationofcervicalorificetodeliveryoffetus.初产妇一般需要1～2h，经产妇只需数分钟，多则1h。generally1～2hforprimparaandseveralminutes,1hatmostformultipara,第三产程（ 胎盘娩出期）；从胎儿娩出到胎盘娩出。Thethird

7、stageofdelivery(deliveryofplacenta):fromdeliveryoffetustodeliveryofplacenta.约需5～15min，一般不超过30min。generally5～15min,nolongerthan30min产程的分期StagesofDelivery总产程：规律宫缩---胎儿胎盘娩出Theoverallprocess:fromuterinecontractiontodeliveryoffetusandtheplac