Labour Flashcards
Three phases of 1st stage of labour are..
Latent phase
Active phase
Transition phase
In the latent phase of labour, there is _____ cervical dilation progressing at _____ an hour with _______ contractions
0-4cm dilation, 0.5cm an hour (nulliparous)
- Irregular contractions
In the Active phase of labour, there is _____ cervical dilation progressing at _____ an hour with _______ contractions
4-7cm dilation, 1cm per hour
- Regular, longer contractions
In the transitional phase of labour, there is _____ cervical dilation progressing at _____ an hour with _______ contractions every _____ minutes
7-10cm dilation
- Regular contractions every 2-3 mins
Delay of the first labour stage occurs when there is _______
<2cm cervical dilation in 4 hours.
First line management of crossing the ‘alert’ line in a partogram
Amniotomy, repeat assessment in 2 hours.
First line management of crossing the ‘action’ line in a partogram
Escalation to obstetric-led care
Delayed 2nd stage of labour occurs when…
Pushing lasts for >2 hours in nulliparous or 1 hour in multiparous
Causes of delayed 2nd stage of labour
3 Ps
- Power: weak uterine contractions
- Passenger: fetal complications
- Passage: shape/size of pelvis
Fetal qualities that can delay labour
Macrosomia
- shoulder dystocia can occur
Attitude
- Posture of the fetus
Lie
- Oblique and transverse
Presentation
- Breech/ shoulder
Delayed 3rd stage of labour is defined as…
> 30 mins with active management
> 60mins with physiological management
Risk factors for shoulder dystocia
Macrosomnia
Small pelvis
Interventions for shoulder dystocia
- McRoberts’s position (legs brought behind head)
- Pressure on pubic symphysis (pressure on anterior shoulder)
- Rubin’s manoevre
- Wood’s screw manoevre
Signs of shoulder dystocia
Obstruction in delivering shoulders
Failure of restitution (face remains downwards)
Turtle-neck sign (head retracting back to vagina)
Rubins manoevre
Manoevre for shoulder dystocia
Involves putting forward pressure on posterior aspect of anterior shoulder
