Birth and Lactation Flashcards

Question

uterine contractions

Answer 1

tightening and shortening of uterine muscles allows the progressive dilatation of the cervix upper segment thickens and shortens and foetus is propelled down the birth canal

Answer 2

upper and lower poles of the uterus act in harmony with contraction and retraction of the upper pole dilatation of the lower pole to allow expulsion of the foetus

Answer 3

following each contraction the muscle fibres don't completely relax as they retain some of the shortening of contraction leads to progressive shortening snd thickening of upper uterine segment and dimihsing of uterine cavity to accommodate the descending foetus

Answer 4

necessary for efficient dilatation and effacement of the cervix women who are dehydrated frequently experience preterm labour can be stopped by rehydrating

Answer 5

like waves composed of increment, acme and decrement

Answer 6

in its transverse diameter

Answer 7

AP diameter

Answer 8

slight mobility increases the available space in the outlet

Answer 9

soft tissues of the cervix, vagina and perineum must stretch to allow passage of the foetus through the axis of the birth canal progesterone and relaxin help facilitate the softening and increase the elasticity of the muscles and ligaments

Answer 10

lie presentation presenting part attitude denominator position

Answer 11

relationship of the fatal long axis to that of the uterus, 99% longitudinal positions are longitudinal, transverse, oblique

Answer 12

cephalic, breech, shoulder, compound

Answer 13

complete footling frank

Answer 14

e.g. a hand

Answer 15

the part of the foetus that lies at the pelvic prim or in the lower pole of the uterus cephalic, breech, face, brow, shoulder

Answer 16

relationship of the fetal head and limbs to its body fully flexed, deflexed, partially or completely extended

Answer 17

The part of the presentation used when referring to the foetal position in relation to the pelvis. occiput, sacrum, mentum, acromion

Answer 18

Relationship of the denominator to six key points on maternal pelvic brim. left and right anterior, lateral and posterior. Further two points are direct anterior and direct posterior. Occurs when the widest presenting transverse diameter has passed the brim of the pelvis. Biparietal diameter at 9.5 centimetres in cephalic presentation

Answer 19

Left occipital anterior, right occipital anterior - lateral (or transverse), posterior, direct occipatal anterior, direct occipital posterior

Answer 20

frontal eminence

Answer 21

DOA it is the smallest diameter presents in the pelvis SVD is possible with OP positions and mento anterior

Answer 22

when the widest transverse diameter of the presenting part has passed through the pelvic inlet measured in 1/5s when > 2/5s palpable PA= not yet engaged

Answer 23

biparietal

Answer 24

form 38 weeks gestation

Answer 25

when the biparietal has passed the plane of the pelvic brim

Answer 26

emotional disturbances

Answer 27

may stimulate both alpha and beta receptors of the myometrium and interfere with the rhythmic nature of labour

Answer 28

The head enters the pelvic brim in the OT position The neck is flexed With uterine activity descent follows & engagement occurs Internal rotation Extension External rotation & restitution

Answer 29

Once the presenting part reaches the pelvic floor the fetal head rotates to OA position, less commonly the OP position

Answer 30

Once the head is completely delivered it rotates back to the transverse position along with the shoulders

Answer 31

by applying axial traction

Answer 32

difficulty delivering the shoulders is an obstetric emergency

Answer 33

Cellular changes by which mammary epithelial cell switches from a growing non secretory tissue to a secreting non-growing tissue (initiation of milk secretion)

Answer 34

breast development & colostrum production from from approx. 16 weeks gestation Involves the differentiation of alveolar epithelial cells into lactocytes that secrete colostrum from around 3-4 months of pregnancy.

Answer 35

onset of increased milk secretion occurring between 32 and 96 hours after birth This occurs in response to rise in prolactin and decrease in pregnancy hormones, and milk will ‘come in’ regardless of whether a woman wants to breastfeed or not.

Answer 36

maintenance of milk production from approximately 10 days postnatal This is the long term maintenance and becomes less reliant on prolactin and more on Feedback Inhibitor of Lactation (FIL).

Answer 37

they become bigger, areola and nipple may darken, Montgomery's tubercles appear on the areola to secrete an antiseptic sebum to lubricate the area. The sebum also secretes a scent to entice the baby to begin to search in the area for his first feed. In fair skinned women, may notice ‘marbling’as the blood supply to the breast increases. The breasts may be tender during the early stages of pregnancy due to the ductal growth. May produce colostrum from around 16 weeks gestation

Answer 38

under the influence of oestrogen and progesterone and human placental lactose

Answer 39

thousands of milk producing cells called lactocytes

Answer 40

series of muscle cells called myoepithelial cells help squeeze milk down ducts to the openings in the nipple

Answer 41

Oestrogen and progesterone levels drop Prolactin and oxytocin levels rise in response to touch, smell and sight of baby

Answer 42

hormone responsbile for milk production Responsive to touch & simulation Levels higher at night Frequent contact/feeds sets up long term production

Answer 43

Milk delivery Acts on muscle cells in pulsatile action Levels higher when the baby is near Stress can temporarily delay ‘let down’ reflex

Answer 44

prolactin receptor theory on the cell wall of each lactocyte are prolactin receptors prolactin levels in the blood stream rise n response to touch and suckling by the baby more circulating prolactin due to more frequent contact and suckling greater number of lactocytes that are activated

Answer 45

circadian levels during the nigher are higher than during the day

Answer 46

circulating prolactin in bloodstream controls milk production especially in early weeks post birth volumes can be irregular at first so mothers may experience full breasts ad leaking as supply and demand establishes FIL synthesis by signalling to the cells to stop production down regulation is also caused by pressure within the full breast flattening and expanding the cells and the receptor sites, difficult for prolactin to attach and enter cells

Answer 47

works on feelings and emotions lowers blood pressure and improves sleep reduces stress levels by taking on cortisol reduces pain sensitivity boosts our immune system

Answer 48

packed with protective factors concentrated nutrition strong anti-inflammatory factors stimulates gut growth small volumes, intentionally laxative effect, to clear meconium

Answer 49

helps to minimise jaundice by assisting the passage of meconium containing bilirubin

Answer 50

help to reduce the risk of necrotising enterocolitis especially in pre term babies

Answer 51

less salt higher energy component less protein more lactose more digestible

Answer 52

swallowing is audible and visible sustained rhythmic suck mouth wide open arms and hands are relaxed mouth is moist nappies are soaked minimal discomfort mu feels sleepy and relaxed

Answer 53

mouth wide open less areolar Isabel underneath chin than above the nipple chin touching the breast lower lip rolled down nose free

Answer 54

painful feel heavy warm and sensitive

Answer 55

inflammation of the breast tissue that sometimes becomes infected if left untreated can lead to the development of a breast abscess

Answer 56

Blocked ducts, referred pain from nipple trauma, menstrual like cramps in the early days as the uterus involutes

Answer 57

There are some situations where suppression of breast milk is important,for emotional and physical reasons. for example following a stillbirth. Medication such as cabergoline can be used in such instances

Answer 58

LACTMED BUMPS