Labor and child birth Flashcards
Dilation of the cervix is complete when?
It is 10cm dilated
Name the signs of Imminent delivery?
Bulging or stretching perineum Presenting part on view (anatomy of the baby) Anal pouting Uncontrollable urge to push Urge to purge Grunting "Show"
Resitution is?
The ability for the baby to spontaneously turn and realign the head with the shoulders after emerging from vulva.
Care of a neonate involves?
Management of the Airway Clamp and cut cord Temperature - Dry and keep warm, tactile stimulation Breathing - allow a min for respirations APGAR
What are the elements for APGAR?
Appearance Pulse Grimace Activity Respiratory
These are taken at 1 min and 5 mins after birth
What are the 3 stages of Labor and their signs and symptoms?
Stage 1: Onset of painful regular, strong, rhythmic contractions resulting in dilation of the cervix until it is 10cm dilated cervix.
Contractions are 15-30 mins apart and 10-30 sec in duration. Amnion ruptures, releasing amniotic fluid. Engagement of the head as it enters the true pelvis.
Stage 2 : Time between the complete dilation of cervix or when the mother feels the urge to push, until delivery of the fetus.
Stage 3: Placental seperation, firm round fundus at the umbilicus, small fresh blood loss, lengthening of the cord, delivery of the plecenta
Explain the cycle of Parturation
Imitation of labor: Estrogen from the ovaries induces oxytocin receptors on the uterus. Oxytocin from fetus and mother’s posterior pituitary stimulates uterus to contract and placenta to produce prostaglandins which stimulates vigorous contractions via positive feedback system.
Outline the parameters for a normal labour?
Foetus at term Cephalic presentation - head engaged Completed spontaneously Less than 18hrs No complications
equipment required to birth a baby?
Obstetric kit: Pad, scissors, clamps, bluey Oxygen (inc infant mask & bag) Y-suction catheters Extra towels Warm environment
What do we do when the baby’s head is crowning?
Exert gentle downward pressure ‘flexion’ on the foetal head.
Support the perineum (can use a pad&).
Control the head
When the head is delivered to the brow gently draw the perineum over the face check for cord around the neck- slip over head or clamp if tight.
During delivery what are some considerations we need to do?
Suction if meconium stained liquor and respiratory difficulties occur.
Suction baby’s mouth then nose.
Allow restitution
Gently grasp baby’s head over the ears
With contractions mother can give a gentle push to assist delivery of the shoulders.
Guide head downwards until upper shoulder is delivered.
Then guide the head upwards to deliver the lower shoulder.
Continue observing the perineum for tearing.
Support the neck as rest of the body will slip out.
Place baby on mothers abdo.
Note time of delivery.
Clamp the cord.
What is the maternal care to be provided to the mother after the birth?
Maternal vital signs every 15/60. Feel abdo - another fetus Maternal complications - clean & check perineum for lacerations. PPH Warm, dry and comfortable Monitor fundus and blood loss Keep blood stained material Transport to hospital
What is the process involved with baby taking its first breath?
Once carbon dioxide is no longer removed by the placenta, central acidosis occurs.
This excites the respiratory centres to trigger the first inspiration.
This requires tremendous efforts -airways are tiny and the lungs are collapsed.
Once the lungs inflate, surfactant in alveolar fluid helps reduce surface tension.
Causes of APGAR less than 7?
Respiratory depression Pre-term infant Intracranial trauma Drugs Obstructed airway Congenital abnormalities
What’s the parameters for a normal placenta?
Many loves in tact that are smooth, rounded and even in colour throughout.
Cake like round and 15-20cm width 2-3cm depth.
Maternal lobulated, foetal glassy and shiny.
Any deviation in colour, malformations may indicate foetal distress and need to be communicated at handover.
