Second stage of labour begins with

Ans: a (Complete cervical Dilatation)Ref: William's Obstetrics, 23r ed. Chapter 17The dilatation and the effacement of the cervix occurs in the first stage of the labour. The patient is in active stage of labour once the cervix is effaced and dilated till 3 cm, following this the rate of dilatation is 1 cm/hour in cases of primigravidas and 1.5 cm/hour in cases of multigravidasThe beginning of the 2 stage of labour is characterized by the complete dilatation and the effacement of the cervixThe main aim of the 2 stage of the labor is the expulsion of the foetus through the female reproductive tract. The 2 stage consists of engagement, progressive flexion and descent, internal rotation, restitution, external rotation and lateral flexion for the delivery of the trunk.Engagement occurs when the greatest possible transverse diameter of the foetus enters the pelvic brim.Flexion and descent are the processes which occurs constantly during the 2 stage.Internal rotation is the most important step occurring in the 2 stage.Expulsion of the placenta is the 3 stage of labor which immediately follows the expulsion of the foetus.Once the baby is expelled, active management of the third stage of labour is recommended. In this immediately post the delivery of the baby, and after ensuring that the uterus is adequately contracted, controlled cord traction, uterine massage and administration of uterotonics is carried out.