21) Labour and its Problems Flashcards
What is labour?
Physiological process by which a fetus is expelled form uterus
What are the purpose of uterine contractions?
Dilate cervix
Push fetus through birth canal
How does the fetus contribute to labour?
Fetal glucocorticoids inhibit progesterone
Fetal oxytocin produced
What can be used to dilate the cervix, if required clinically?
Synthetic oxytocin
When can the size of the ‘passenger’ be an issue?
Gestational diabetes
Where is the inlet narrowest?
Obstetric conjugate
Where is the outlet narrowest?
Between ischial tuberosities
When can the number of the ‘passengers’ be an issue?
Twins, can get abnormal presentation
Give examples of some fetal presentations:
Brow, face, cephalic, frank breech, full breech, single footling breech
What are some common causes of maternal mortality?
Pre-eclampsia
Post-partum haemorrhage
Obstructed labour
Unsafe abortion
What are some other methods of delivery that aren’t vaginal delivery?
Caesarean section
Forceps delivery
Vacuum extraction
What factors control bleeding during labour?
Powerful contractions of uterus constrict vessel in myometrium
Pressure exerted on placental site by walls of contracted uterus
Pro-thrombotic state
What is the latent stage of labour?
Onset of labour with slow cervical dilation to 4cm
What is the active stage of labour?
Faster rate of cervical change, 1.2cm per hour, regular contractions
When can ‘passenger’ lie be an issue?
If transverse
