Labour Flashcards
What is the definition of labour?
When a woman is experiencing regular painful uterine contractions
What are the signs of labour?
Regular and painful uterine contractions
Shedding of mucous plug
Rupture of membranes (not always)
Cervical effacement and dilatation
What is stage 1 of labour?
From onset of contractions to 10cm dilated
Latent phase= 0-3cm
Active phase= 3-10cm
Should be having strong contractions lasting approx 45 seconds every 3 mins
How long should 1st stage of labour last?
Nulliparous= 0.5cm/hr (>20hrs is concerning) Multiparous= 1cm/hr (>16hrs concerncing)
What is stage 2 of labour?
Full dilatation to delivery of foetus
Passive 2nd stage is when dialted but not pushing
Active when pushing
How long should 2nd stage of labour last?
No more than 2 hrs in nulliparous
No more than 1hr in multiparous
If this is not met then must assess woman and consider expediting delivery (e.g. forceps/ventouse/CS) unless delivery imminent
What is stage 3 of labour?
From delivery of foetus to delivery of placenta
Physiological- no medications given, umbilical cord left unclamped until it has stopped pulsating and baby to mothers breast to stimulate oxytocin release to separate placenta
Active- with oxytocin or syntrometrine (not in women with HTN) to shorten phase, cord traction can be applied, hand placed on uterus to stop inversion
How long should 3rd stage of labour last?
Physiological no more than 1 hr
Active no more than 30 mins
How is the foetus monitored during labour?
Every 15mins post contraction listen to foetal heartbeat for 1 min (1st stage) and 5 mins in 2nd stage
OR
CTG (continuous monitoring)
When is CTG of the foetus done?
<37wks
Multiple pregnancy
Pregnancy related disease e.g. PET or GSD
Antepartum related disease e.g. haemorrhage
Foetus not cephalic
What monitoring of mother is there during labour?
Obs every hour
Vaginal examination every 4 hours
Contraction frequency and strength
Urine dip every 4hrs (or when urinating) to look for ketones
What are the different degree of tears?
1st degree aka grazes
-do not require stitching
2nd degree
- tearing of perineal muscles
- sutured under LA normally by midwife
3rd degree
-anal sphincter torn-theatre with epidural or spinal
4th degree
- tearing of rectum
- theatre with epidural or spinal
