Labour Flashcards
Progression of smooth muscle in cervix
Decreases from proximal cervix(internal os) to distal cervix
First stage of labour
Onset of regular painful uterine contractions and ends with complete cervical dilation
Latent phase
Onset of contractions to 4cm dilation
When is latent phase said to be prolonged
If more than 8hrs
Contractions <3 in 10 lasting for <20sec
Adequate contractions
3 or 4 in 10 mins lasting 40-60 sec
Mechanism of labour
Engagement
Descent
Flexion
Internal rotation
Extension
Restitution
External rotation
Expulsion
Average duration of 1st stage for multipara and nullipara
8 hrs
12 hrs
Prolonged 1st stage
Beyond 14 hrs
Prolonged 2nd stage
1 hr for multipara
2hr for nullip
Add 1 hr if Epidural is given
Retained placenta
When the placenta has not been delivered 30 mins after delivery of the baby in the absence of active bleeding.
4th stage of labour
First 6 hours after delivery of placenta
Time for checking these parameters in labour
- Contractions
- Fetal Heart
- Descent
- Cervical dilation
- pulse
- BP
- Temperature
- Urinary output
C & F - 30 mins
Descent and cervical dilation
4 hourly
Pulse - 30 mins
BP - 2 hrs
Temp - 4 hrs
Urinary output - 4 hrs
How to record colour of amniotic fluid
I - Intact membranes
C- ruptured, clear
M- meconium stained
B- blood stained
A- absence of fluid
Degree of molding
1st - parietal bones touch each other
2nd - overlap but reducible
3rd - overlap but can’t be separated
Cervical Dilatation denoted by which symbol
Descent
Pulse
BP
Cross
Circle
Dot
Arrow
Denoting contractions
….. - less than 20 sec
Shading - 20 and 30
Solid - more than 40 sec
When not to start patient on partograph
When Dilatation is less than 4cm or greater than or equal to 8cm
What drug differentiates false labour from true labour
Pethidine IM
Comtraindications of ARM
HIV
Hep B
Precaution for augmenting labour
Rule out CPD
Abnormal labour
Becomes abnormal if there’s poor progress and fetal shows signs of compromise
Define prolonged labour
Lasting more than 14 hrs
In which positions does deep transverse arrest occur
Occipito posterior
The occipito frontal diameter gets caught up at the ischial spine
How is incordinate contrx corrected in nullip
Oxytocin infusion
Obstructed labour
Lack of progress in spite of adequate uterine contractions
Empty sleeve seen in
Obstructed labour
Bandyls ring
A pathological retraction ring seen as a ridge above pubis symphysis and marks junction between the upper and lower uterine segment
GAG replaced by
Hyaluronic acid
