Obstetric and Gynecological Nursing - The Carter Center

and descend. The anterior shoulder reaches the pelvic
floor and rotates forward, this cause.
7. External rotation of the head:
8. Lateral flexion of the body: The shoulders escape under
the symphysis, and the rest of the body is born by lateral
flexion.
NOTE: The mechanism in any other position follows the same
principles of
ENGAGEMENT – DESCENT – INTERNAL ROTATION,
BIRTH AND EXTERNAL ROTATION.
MANAGEMENT OF THE SECOND STAGE
Once the patient is in the second stage the nurse must not
LEAVE HER, and a constant and careful supervision must be
kept on her:
1. General condition, pulse, uterine contractions & Vulva
2. Bladder should be empty
3. Fetal heart more frequently (after every second contraction)
4. Descent of the presenting part and programs is soon.
5. Membrane should be ruptured
Preparation for Delivery:
A. Equipment: have ready
Delivery: Set with 2 clamps, scissors, sterile towels, cord tigh,
Bowl and kidney dish
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