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Reproduction Week 4 2018/19 > 2: Normal labour and peurperium > Flashcards

2: Normal labour and peurperium Flashcards

1
Q

What is a birth plan?

A

Note of what the woman wants re: labour and post birth

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2
Q

Is a woman required to have a birth plan?

A

No

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3
Q

Which hormones

a) encourage
b) discourage

uterine contractions?

A

a) Oestrogen, oxytocin

b) Progesterone

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4
Q

Which chemicals are released in response to oxytocin, inducing labour?

A

Prostaglandins

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5
Q

Stretch of the uterine muscles increases their excitability.

What can therefore trigger labour?

A

Growth of baby

Multiple pregnancy

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6
Q

What is the Ferguson reflex?

A

Oxytocin release in response to cervical stretch

Encouraging uterine contractions and childbirth

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7
Q

Which two hormones trigger prostaglandin formation?

A

Oestrogen

Oxytocin

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8
Q

Which reflex causes oxytocin release in response to the stretching of uterine / cervical muscle?

A

Ferguson’s reflex

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9
Q

What ruptures at the beginning of labour?

A

Amniotic sac

“floods” of amniotic fluid

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10
Q

What is membrane rupture also known as?

A

Water break

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11
Q

When can membrane rupture occur?

A

Pre-labour (as intended)

Pre-term (bad)

Or baby can be born “in a caul” i.e still in the amniotic sac

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12
Q

What happens to the cervix as labour progresses?

A

Softens and dilates

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13
Q

What score is used to determine whether or not a medical induction of labour will be required?

A

Bishop score

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14
Q

What type of labour is advised if a woman’s Bishop score is high?

A

Spontaneous labour

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15
Q

What type of labour is advised if a woman’s Bishop score is low?

A

Medical induction of labour

manual membrane rupture –> oxytocin

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16
Q

How many stages of labour are there?

A

Three stages

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17
Q

As labour progresses, the ___ dilates until expulsion occurs.

A

cervix dilates

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18
Q

How long does labour last on average?

A

Around 10 hours

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19
Q

What diameter does the cervix contract to in the first stage of labour?

A

3cm

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20
Q

What diameter describes complete dilatation of the cervix?

A

10cm

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21
Q

In which stage of labour is the baby actually delivered?

A

Third stage

22
Q

How long does the third stage of labour last?

A

10 minutes

23
Q

After how long in the third stage of labour would you consider a caesarean section?

A

1 hour

24
Q

What is the medical name for false labour contractions?

A

Braxton-Hicks contractions

25
Q

When do Braxton-Hicks contractions occur?

A

Third trimester

26
Q

What increases a woman’s chances of having Braxton-Hicks contractions?

A

Multiparity

27
Q

Which hormone is primarily responsible for true labour contractions?

A

Oxytocin

28
Q

Describe true labour contractions.

A

Regular rhythm

Duration = 10 - 45s

Frequency = 1 - 4 / 10 mins

Gradually shortening intervals

Painful

29
Q

What is the purpose of labour contractions?

A

Pushes baby down into the pelvis ready for delivery

30
Q

The power of uterine contractions is dependent on what?

A

Uterine muscles

31
Q

How do true labour contractions change over time?

A

More frequent

Longer duration

Greater power

32
Q

The shape of a woman’s ___ will influence the success of natural birth.

A

pelvis

33
Q

What bony features can be felt on vaginal examination to figure out the lie and presentation of a baby?

A

Sutures

Fontanelles

34
Q

What therapy do many women require during labour?

A

Analgesia

35
Q

What analgesic drugs are used in labour?

A

Paracetamol

Co-codamol

progressing to diamorphine (which is heroin)

36
Q

What surgical methods of analgesia can be used in labour?

A

Spinal / Epidural anaesthesia

Pudendal nerve block

37
Q

What gas can be used to temporarily reduce labour pain?

A

Entonox

‘laughing gas’

38
Q

What is an important effect of spinal anaesthesia re: labour?

A

Woman can’t push (contractions still present but numb)

Numb from the waist down (so woman can’t walk about)

39
Q

What are the seven cardinal movements of labour?

A

Engagement

Descent

Internal rotation of head

Flexion of head

Crowning and extension of head

Restitution (external rotation of head back in line with body)

Expulsion (release of both shoulders with careful maneouvres)

40
Q

What is engagement?

A

Widest part of presenting part descends below pelvic inlet

41
Q

How many fifths of the foetal head needs to pass beneath the pelvic inlet to be described as engaged?

A

3/5ths

42
Q

Why is the baby’s head externally rotated during engagement?

A

So shortest head diameter (biparietal diameter) and can fit through largest pelvic diameter (anteroposterior diameter) during descent

43
Q

Why does the baby flex its head during an occipito-anterior birth?

A

Smallest possible diameter

44
Q

Does the rotation of the body change during birth?

A

No

It’s all head movements

45
Q

How long after birth should the umbilical cord be clamped and cut?

Why?

A

3 - 5 minutes

Allows continued transfer of blood between mother and foetus

46
Q

What sort of contact improves bonding and breastfeeding success after birth?

A

Skin-to-skin contact

47
Q

How long after birth is the placenta expelled on average?

A

5 - 10 mins

48
Q

Which drug is often given during the third stage of pregnancy to encourage expulsion of the placenta?

A

Oxytocin

49
Q

Which hormones are responsible for the production and expulsion of breast milk?

A

Production - prolactin

Expulsion - oxytocin

50
Q

What is a mother’s first breast milk called?

What’s special about it?

A

Colostrum

Contains very little fat and loads of immunoglobulins

Reproduction Week 4 2018/19 (9 decks)

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