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year 3 revision > 1st Stage of Labour > Flashcards

1st Stage of Labour Flashcards

1
Q

How does the uterus grow during pregnancy?

A

First 4 months = Hyperplasia (increased organ tissue due to cell proliferation)
Final 5 months = Hypertrophy (increased organ tissue due to cell enlargement)

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2
Q

What are the 2 segments of the uterus called?

A

Fundus and Isthmus

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3
Q

What is quiescence?

A

The continuous spontaneous contractibility of uterine muscle while remaining ‘quiet’ (when this becomes stronger = Braxton-Hicks)

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4
Q

When do Braxton-Hicks usually occur?

A

In the final 6 weeks of pregnancy

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5
Q

What might women notice towards the end of pregnancy?

A
  • Mood swings
  • Difficulty walking
  • Relief of pressure at the fundus
  • Increased pressure in the pelvis
  • Nesting
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6
Q

What softens the cervix prior to labour?

A
  • Increased vascularity and water content

- Structural changes in connective tissue

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7
Q

What is effacement?

A

The shortening and thinning of the cervix by contractions

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8
Q

What is the ‘show’?

A

The operculum (mucous plug that is seen during effacement or early dilation)

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9
Q

What is assessed using a BISHOP score?

A
  • Station
  • Position
  • Consistency
  • Length
  • Dilatation
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10
Q

What does Cortisol do to encourage labour?

A

Affects and reduces maternal production of progesterone

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11
Q

What does Progesterone do to encourage labour?

A

Levels decrease (as it inhibits contractions)

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12
Q

What does Oestrogen do to encourage labour?

A

Levels increase, stimulating oxytocin receptors in the myometrium and encouraging the placenta to release prostaglandins

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13
Q

What do Prostaglandins do to encourage labour?

A

Ripen the cervix and induce labour

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14
Q

How can prostaglandin synthesis be stimulated?

A
  • Sex
  • VE and sweep
  • ARM
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15
Q

What does Oxytocin do to encourage labour?

A

Encourages the uterus to contract

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16
Q

What is the Ferguson’s reflex?

A

Pressure on the cervix from the PP increases oxytocin production, causing contractions

17
Q

What does Relaxin do to encourage labour?

A

Promotes cervical ripening
(but also inhibits contractions and levels are usually low in late pregnancy - high levels are associated with preterm labour)

18
Q

What are the 3 phases of the 1st stage of labour?

A
  1. Latent Phase
  2. Active Phase
  3. Transitional Phase
19
Q

What occurs in the latent phase?

A
  • Cervix dilates up to 4cm
  • Effacement
  • Irregular contractions
  • Can take up to a few days
20
Q

What occurs in the active phase?

A
  • Regular contractions (approx. 4:10)

- Dilation from 4-10cm (approx. 0.5cm/hr)

21
Q

What are some common features of the transitional phase?

A
  • Panic and fear
  • Nausea
  • Heavy show
  • Urge to push
  • Irritability
  • Slowing of contractions
  • Asking for more pain relief
22
Q

What role does Elastin have?

A

Hormone that enables contraction and retraction and allows the uterus to regain shape after delivery

23
Q

Where are the contractions strongest?

A

At the fundus

24
Q

How do the 2 segments of the uterus work together?

A
  • Upper segment contracts and retracts strongly to expel the foetus
  • Lower segment contracts slightly and dilates to allow expulsion
25
Q

What is the Retraction Ring?

A

A ridge that forms between the upper and lower segment

26
Q

What is the Bandl’s Ring?

A

An exaggerated Retraction Ring located above the symphysis which can be a sign of obstructed labour

27
Q

What are some external signs of established labour?

A
  • Rocking
  • Toe curling
  • Purple line
  • Mexican hot legs
28
Q

What is the average duration of 1st stage?

A 
Primip = 8-18 hrs
Multip = 5-12 hrs
29
Q

How can delay in 1st stage be diagnosed?

A
  • <0.5cm per hr
  • VE (descent/rotation of foetus)
  • Changes in contractions not present
30
Q

What interventions should be considered if 1st stage is delayed?

A
  • ARM
  • Analgesia
  • Synto
  • More regular VEs
31
Q

What temperature should the water be for a pool birth?

A

1st stage = 35-37.5

2nd stage = 36.5-37.5

32
Q

What is the association between pethidine and pool births?

A

If IM pethidine is given, you must wait 3-4 hours before the woman gets in to the pool

33
Q

When should a partogram be commenced?

A

Onset of established labour (4cm, cont 3-4:10) or when oxytocin is commenced

34
Q

What should be done if a woman comes into ANDU with a suspected SROM?

A
  • Midwife speculum (if LR)
  • Lie down for 30 mins before
  • CTG not needed if LR

year 3 revision (49 decks)

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