1st Stage of labour Flashcards
- Onset of labour - Latent stage - Environment - Physiology
Name some factors for the theories of physiological onset of labour
- Maternal and fetal hormone interaction
- High levels of oestrogen
- Softening of the cervi via prostaglandins released from the placenta
Define latent phase of labour
WHO and NICE .
How long approx does it last for
(WHO) painful contractions, some degree of effacement and dilation up to 5cm.
(NICE) time when there are painful contractions AND effacement and dilation up to 4cm.
6-8hrs
Define active 1st stage of labour.
Regular painful contractions AND cervix undergoes more rapid dilation 4cm+(NICE) or 5+cm(WHO) until 10cm.
Management of latent stage?
- Home is the best place to stay relaxed … oxytocin vs stress and adrenaline
- rest between contractions, sleep, inform of when to call again
Define effacement and dilatation
Rate of dilatation per hr?
Why does dilatation happen ?
Effacement - inclusion of the cervix into the cervical canal, thus it thins
Dilatation - How wide the cervix is , cm.
10cm = full dilatation
0.5cm an hour
Pressure from intact membranes or presenting part or both on cervix
Operculum ?
- Mucus plug
- can happen whenever
- Blood stained, snotty, not fresh blood
Amniotic fluid colours Green Golden Greenish yellow Dark coloured Dark brown
Green - meconium stained Golden - Rh incompatibility Greenish yellow - post maturity Dark coloured - concealed accidental haemorrhage Dark brown - IUD
SROM
ARM
PROM
PPROM
Spontaneous rupture of membranes
Artificial rupture of membranes
Premature rupture of membranes
Preterm Premature rupture of membranes
what is the retraction of uterine muscles?
contract and retract means that the muscles dont go back to the previous length, some of the shortening is retained.
Powers
Passenger
Passages
Powers = contraction of uterus primarily and maternal effort secondly Passenger = fetus Passages = pelvis
in 1st stage, how often do you auscultate the fetal heart ?
How often should a CTG be categorised ?
How often do you document frequency of contractions?
How often document pulse?
Temp and BP
Offer of VE?
15 mins or after every contraction Every 30 mins. buddy every hour Every half hour Every hour 4 hourly 4 hourly
Physiology of oxytocin & uterus & cervix
Oxytocin from hypothalamus
Uterus responds and contracts
Causes pressure on the cervix which activates sensory nerves
Contractions at the end of 1st stage .
3-4 in 10 mins , lasting 45-60 seconds
Is it safe to eat and drink during labour?
Yes. if low risk.
NICE recommend isotonic drinks at a controlled rate
Why is emptying bladder frequently important ?
Doesn’t hold fetus up
Reduced risk of injury from being full during labour and birth
