False vs True Labour Flashcards
What are the physical premonitory signs of labour?
-Expansion of LUS
-Engagement of fetal head
-Lightening of diaphraghm as baby moves off it
-Leg cramps due to pressure on nerves as they pass throu the obturator foramen in pelvis
-Walking becomes more difficult
-Incrs venous stasis=oedema
-Stress incontinence
-Incrsd vaginal secretions
-Weight loss due to fluid loss
-Diarrhoea, indigestion, nausea
What features of true labour are missing from premonitory labour
Effacement and dialation of the cervix
Sudden Burst of energy?
Been reported a sudden burst of energy 24-48hrs before labour
What are the behavioural premonitory signs of labour
-Nesting
-Burst of energy
-Increased endorphins
-Broken sleep
-Amnesia (baby brain)
How does the cervix become softer?
Collagen fibres in cervix are broken down by enzymes
As the fibres change, their ability to bind tg decreases while water content of cervix increases
This makes the cervix softeer
What is the ‘show’ during pregnancy
When the mucous plug (operculum) is shed per vaginum
May be bloodstained
What is a bloody show a sign of?
A sign that labour may begin within 24-48 hrs
How does a mucous plug become bloody?
It is from ruptured capillaries in the parietal decidua where the chorion has become detached from the cervix.
A rough VE may have also caused blood
What does PROM mean
Prelabour Rupture of Membranes at Term
Spontaneous rupture of membranes at or beyond 37 weeks + prior to onset of labour
What risks does PROM impose?
-Maternal and neonatal infection
-Prolapsed cord
-FHR changes=operative birth
-Low 5min APGAR score
What is the maximum time that should be left before giving birth when PROM
24hrs
as it increases risk of infection the longer the membranes are ruptured
Induction of labour is an intervention to start labour within a safe timeframe.
How to check if membranes are ruptured (waters broken)
Speculum examination to see pooling of fluid in posterior vaginal fornix
Ultrasound-oligohydramnios-
Amnisure test
What could amniotic fluid look like?
Colour=Clear,pinky,meconium
Volume=Small/large amnt
Odour=No odour, foul smelling
What does it mean if amniotic fluid is foul smelling
Possible indication of infectionor meconium
Contraindications to regular management of PROM
Mat pyrexia <36, >37.4C
Mat tachycardia >100
Fet tachycardia >160
Meconium present
Suspected vag infection
Antepartum hemmorrhage (APH)
Hypertension
Multigravida
Malpresentation
FH not engaged
When a womans membranes rupture you should advise her to
-Not have sex or put anything in her vag
-Wipe front to back after BO
-Showering and bathing is ok
What happens if woman doesnt start labour 24hrs after ROM
Induction of labour
Hospital stay to obs baby
After birtha symptomatic babies to b observed at 1,2, then 2hrly for 10 hours
Whats the only way to differentiate between true and practice laboyr?
VE to assess effacement and dialation
Overview of difference between true and false labour
TRUE LABOUR
* Contractions occur at regular
intervals
* Interval between contractions
gradually shortens
* Contractions inc in duration
and intensity
* Discomfort begins in back to abdomen
* Intensity increases w
walking
* Changes and effacement
are progressive
FALSE LABPUR
* Contractions irregular
* Usually no change
* Usually no change
* Discomfort is usually in the
lower abdomen and groin
* Walking has no effect on or
lessens contractions
* No change
What should a woman do when shes in Early labour?
-Act normal
-Avoid fatiguing excersises
-Rest,sleep,eat
-Get organised
-Organise childcare
-Toilet for comfort
