LABOUR Flashcards
Explain the hormonal initiation of labour
Increase in oestrogen/progesterone
- oestrogen stimulates uterine contractions
- increase prostaglandins
Oxyctocin release
Ferguson’s reflex
- foetal stretch of cervix causes oxyctocin release -> uterine contraction and prostagladins -> increase in oxyctocin (+ve feedback loop)
What does it mean to be ‘born in a caul’?
Born in membranes
What chemical is responsible for the breaking of collagen bonds in the cervix?
HCl
What scoring system is used to determine if a mother is likely to need to be induced?
Bishop’s score
Describe what happens in the 3 stages of labour?
Stage 1 Latent - until 4cm dilation. - this can be done from home Active - 4-10cm dilation - increasing contractions - v. painful stage
Stage 2
- from 10cm dilation -> delivery
Baby passes through the cervix
Stage 3
- placenta is expelled
How many cm is fully dilated?
10cm
What consitutes a prolonged stage 2?
Nulliparous
- pain relief -> 3hrs+
- no pain relief -> 2hrs+
Take an hour away for multiparous women
Expulsion of the placenta takes on average 10mins.
What is used to encourage passage?
Why is interference encouraged?
Oxyctocin + controlled cord traction
Reduces PPH
What is the max time a contraction will last?
45s
Where is the pacemaker for uterine contractions found?
Tubal ostia - opening to fallopian tubes
What is the most ideal pelvic shape?
Gynecoid
What position do you want the baby to be in during the entire labour?
Ideally anterior occipital
(transverse when coming through the pelvic inlet - AO when through pelvic outlet)
Then external rotation to get shoulders out
How can you determine babies position coming out the womb?
feel fontanelles
Why is skin-to-skin contact important?
When is the umbilical cord cut?
Keeps baby calm
1-3mins post birth
What is the most common way for the placenta to shed?
Matthews Duncan - from sides rather than centrally (Schultze)
