Labor

Question 1

Definition of labor

Answer 1

Its a process by which the uterus expels the fetus and the placenta at or beyond 28 weeks

Question 2

Characters of normal labor (10)

Answer 2

Spontaneous onset(expulsion) , through birth canal of single living mature fetus presented by vertex no fetal or maternal complications in reasonable 3-18 hours with no interference (episiotomy)

Question 3

Cause of the onset of labour

Answer 3

Progesterone withdrawal
Prostaglandin release
Decrease in placental oxytocinase
Fetal cortisol theory
Estrogen- oxytocin effect
Uterine distension

Question 4

Zhang 2010 duration of 1st stage of labour

Answer 4

Latent phase Pg 20 hours Mp 14 hours 4 cm up to 6 cm
Considered prolonged if <1.2/hour cm Pg , <1.5 cm/hour in mp in active phase

Question 5

Anteroposterior diameters 3x2

Answer 5

1) suboccipito-bregmatic 9.5 cm head is completely flexed OA
Suboccipito-frontal 10cm not completely flexed OA fully flexed head extends after crowning
Occipito-frontal 11.5 cm deflexed after breech OP head extends before crowning in face to pubis delivery

Vertical point (centre of the saggital suture midway between post and ant fontanelles)
2) submento-bregmatic 9.5cm face presentation fully extended
Submentovertical 11.5cm face presentation not fully extended
Mento vertical 13.75cm brow cannot be vaginally delivered