Chapter 2 - First stage of laboru

Question 1

Normal labour

Answer 1

Spontaneous onset of regular painful uterine contractions associated with the effacement and progressive dilation of the cervix & descent of PPP with or without ‘show’ or ruptured of membranes

Question 2

Diagnosis of labour

Answer 2

If contractions are painful and regular

Cervix is >4cm dilated ( active phase`)

Question 3

? active phase

Answer 3

If patient is in latent phase of labour it may be nessary to perform two examinations at least 2 hours apart

Question 4

Braxton hicks

Answer 4

Uterine contractions without the effacement and dilation of the cervix occurs in 3rd trimester

Question 5

Management of 1st stage

Answer 5

• initial assessment
• observations and intervention if labour becomes abnormal
• Close monitoring of the fetal and maternal condition
• Adequate pain relief
• Emotional support and adequate hydration

Question 6

General examination 1st stage

Answer 6

• ? jaundice
• the state of hydration
• her blood pressure, pulse and temperature
• breathing
  any odema
  frequency of bladder emptying and urinary output should be noted

Question 7

VE

Answer 7

abnormal discharge from the vagina
Colour and quantity of any amniotic fluid - clear, blood stained or contains meconium
Consistency, position, effacement and dilation of the cervix
the presenting part in relation to the ischial spines, caput and moulding of the head
the bony pelvis should be assessed with regard to its adequacy for childbirth

Question 8

Investigations

Answer 8

Urine sample
Oral intake
Rehydration - Hartmans solution

Question 9

Hartmans solution

Answer 9

a more physiological fluid and electrolyte balance

Avoids water intoxication if intravenous oxytocin is used over a long period in high dose