embryology birth

Question 1

definition of a normal birth

Answer 1

• the baby is born after a period of pregnancy of 259-293 days
• labour has a duration between 3 and 18 hours
• the baby is born with its head in face-up position rotating to face-down position
• the amniotic sac breaks during the contractions
• blood loss of the mother is no more than 500ml
• mother and baby are not considerably endangered

Question 2

Signs for an approaching delivery

Answer 2

1. periodic contractions (intervals < 10 min.)
2. loss of amniotic fluid
3. vaginal bleeding

Question 3

Trigger for contractions

Answer 3

Trigger: Protein

origin: in the lungs of the baby

=>

Trigger: release of hormone oxytocin

Origin: placenta

=>

Initiation of birth

Question 4

hormone oxytocin

Answer 4

responsible for loyality to your partner, makes us feel physically connected to each other

breastfeeding mother & child

oxytocin = high (-> chance of cheating is lower)

Question 5

First stage

Answer 5

1. Contractions

Duration: 15-20h

Wehen= muscle contractions of the uterine muscle

After each contraction the musclefibres of the uterus do not fully return to their original length, but stay a bit shortened. -> The uterus wall is pulled over the head of the baby

Result of this process: cervix opened up to a max of 10cm

Question 6

2. Stage

Answer 6

2. Descent and delivery of the infant

Duration: several minutes up to one hour

• this stage begins when the cevix is fully dilated
• Distance between p and s: 11cm
• Hormonal influence leads to: softening of the public bone
• Coccyx: Can be moved 2cm
• The baby is pressed from the uterine and abdomal muscle out of the birth canal head first; pressure may reach a level of 20 kPa
• When passing the birth canal, the child is performing a helical rotation into a face-down position.

Question 7

coccyx

Answer 7

Steissbein

can be moved for 2cm

Question 8

Where to deliver a baby

Answer 8

• at home (with midwife)
• delivery room

Question 9

How to deliver

Answer 9

• lying on the back (supine)
• in the water
• standing

Question 10

3. Stage

Answer 10

3. Delivery of the placenta

Duration: 15 min up to one hour…

-> until the placenta is completely delivered

After delivery: mother is to be observed for another 2h

=> the process of labour is now offically finished

Question 11

Complications of birth:

Position

Answer 11

Longitudinal position (99,5%): Normal delivery

Transverse position (0,5%): Vaginal delivery is not possible

Question 12

Complications of birth:

Size of birth canal

Answer 12

The canal’s diameter is too small for the cranum of the baby. Vaginal delivery will not be possible.

Question 13

Complications of birth:

Umbilical cord prolapse (0,14-0,62%)

Answer 13

The fetus moves downward into the pelvis and puts pressure on the cord.. As a result, oxygen and blood supplies to the fetus are diminished or cut-off and the baby must be delivered quickly.

Immediate consequence: lock of oxygen

Lasting effects on the child: brain damage

Question 14

Complications of birth:

placental abruption (1%)

Answer 14

Placental lining has separated from the uterus of the mother too early

Lasting effects on the child: lack of O2 -> brain damage

Lasting effects on the mother: loss of blood, severe case of shock (can cause death)

Question 15

Solutions for a successful birth in case of complications:

1

Answer 15

1. episiotomy (Dammschnitt)

This procedure is necessary when the tissue of the perinaeum cannot expand enough for the head of the baby to pass through without rupture

Question 16

Solutions for a successful birth in case of complications

2

Answer 16

2. Caesarean section

This procedure is the safest way of birth when a vaginal birth is risky or impossible. In Switzerland 15-20% of all babys are delivered this way.

Where and how is the section made?

Nowdays: Transverse cut just above the edge of the genital hair

Question 17

PCA

Answer 17

patient controlled analgesia

(the more it is used the more the woman’s body is getting used to it)

Question 18

DDA

Answer 18

peridural analgesia