Intrapartum

Question 1

What is labour?

Answer 1

It is the physiological process by which a baby is delivered to the outside world

Question 2

When does childbirth begin?

Answer 2

It usually begins following about 37-42 weeks after conception

Question 3

How long does labour lasts?

Answer 3

It varies
Sometimes a few days
Active labour : 8 - 18 hours

Question 4

What are the 3 mechnical variables?

Answer 4

the 3 Ps

1. Power
2. Passenger
3. Passage
4. Psyche of a mother

Question 5

What is power?

Answer 5

It refers to the force generated during a uterine contraction

Question 6

What is the result of more power?

Answer 6

more successful outcome

Question 7

What is the assessment?

Answer 7

observation of the mother and
palpation of the fundus of the uterus or using
external tocodynamometry

Question 8

How many contractions are there?

Answer 8

3-5 contractions in 10 mins, lasting 50-60s

Question 9

What is passenger?

Answer 9

Passenger is the fetus

Question 10

What is the fetus usual size?

Answer 10

2.8kg-3.5kg

Question 11

What is the lie?

Answer 11

Longitudinal, transverse or oblique

Question 12

What is the presentation?

Answer 12

The leading fetal part in the pelvic?

Question 13

What are the positions of presentations?

Answer 13

vertex, breech

Question 14

What is attitude?

Answer 14

The degree of flexion of the fetal head

Question 15

What is the position?

Answer 15

Relationship relation of the presenting part to a specific quadrant of a woman’s pelvis e.g. right occipital anterior

Question 16

What is station?

Answer 16

The degree of decent of the leading part, -2, -1, 0

Question 17

What is passage?

Answer 17

It consists of bony pelvis + soft tissue ( cervix, pelvic floor musculature )

Question 18

What are the stages of labour

Answer 18

1st stage : onset of labour -> dilation to 10cm
2nd stage : time of 10cm -> delivery of baby
3rd stage : time from delivery of the baby -> the expulsion of the placenta
4th stage : Immediately after the baby

Question 19

What is the 1st stage?

Answer 19

The uterine to begin rhythmic contractions which steadily increases in strength and frequency

The uterine contractions

1) dilate the cervix
2) push the fetus through the birth canal

Question 20

What are the signs and symptoms of labour?

Answer 20

Painful,
Rhythmic uterine contractions 
Present of show ( blood and mucous discharge )
or 
leaking liquor ( amniotic fluid )

Question 21

The 1st stage is divided into 2 phrases

Answer 21

Latent phase and active phase

Question 22

Latent phrase

Answer 22

< 3cm

slow cervical dilation

Question 23

Active phrase

Answer 23

> 3cm
Contractions are stronger, last longer and > regular

Faster rate of cervical dilation
~ 1cm per hour

Question 24

What is the 1st stage of labour?

Answer 24

• Vaginal examination ( cervix, forewaters, station, position, moulding, pelvic capacity )
• Cleanliness and comfort ( clothing, bath / shower , bowel preparation )
• Documentation / Records
  ( Partogram cervicograph, midwifery / nurses notes, obstetric records, IMR )

Question 25

2nd stage of labour

Answer 25

Time from full dilation of the cervix to delivery of the fetus or fetuses

subdivided into 2 phases

a) passive ( no maternal urge to push, fetal head is still relatively high in pelvis )
b) active ( strong maternal urge to push, fetal head is low - causing “ bear down” reflex )

Question 26

2nd stage of labour

Answer 26

Management and care

• Coach on ‘ pushing ‘
• Perineal cleaning
• Episiotomy
• Birth
• Cutting and clamping the umbilical cord

Question 27

3rd stage of labour

Answer 27

The expulsion of the placenta