Summary
Samenvatting de normale baring
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Samenvatting de normale baring - het urogynaecologisch stelsel
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De normale baringInleiding en definities
Arbeid = uteriene contracties ontsluiting geboorte
Arbeid begint bij de ‘tekenen’
= verlies van slijm en bloed, uteriene contracties en afloop vruchtwater
Arbeid registreren: buiten buik of in vruchtwater
o Frequentie: 3-5/10 min
o Amplitude: rustdruk < 20 mmHG; piek = 50-100 mmHg
o Duur
o regelmaat
maternele factoren: uitdrijving
foetale factoren: timing cortisol van foetale bijnier
K1: uitdrijvende Kracht:
arbeid = samentrekking glad spierweefsel
Persen = ook contractie van dwarsgestreepte buikspieren
K2: GeboorteKanaal:
Benige baringskanaal met bekkenas van 90° = kromme cilinder
Benige bekkeningang = breder dwars dan V-A (conjugata vera)
Benige bekkenholte; Midden = ronde vorm
Benige bekkenuitgang = kleinste doorgang: bekkenuitgang langer V-A dan dwars
Goed vaginaal OZ
o Promontorium niet voelen
o Sacrum concaaf in lengterichting
o Spinae amper te voelen
o Arcus pubis met twee vingers
Weke baringskanaal: cervix, vagina en BB
4 fases van de cervix:
o Verweken
o Verstrijken
o Anteriorisatie
o Ontsluiting
Bishop score: punten geven van 0-3
K3: het Kind:
Aard van voorliggend deel
o Hoofdligging
Kruin
aangezicht
o Stuitligging
o Dwarsligging
o Weten wat smalste diameter is = kind in volledige flexie
o BPD = bipariëtale diameter
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