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Obstetrics > Labour > Flashcards

Labour Flashcards

1
Q

What is the first stage of labour?

A

From the onset of labour to up to 10cm dilated

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2
Q

What is the second stage of labour?

A

From 10cm cervical dilation up to the delivery of the baby

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3
Q

What is the third stage of labour?

A

From delivery of the baby until delivery of the placenta

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4
Q

What is the latent phase of the first stage of labour?

A

Up to 3cm cervical dilation
Irregular contraction
Progresses at 0.5cm per hour

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5
Q

What is the active phase of the first stage of labour?

A

From 3cm to 7cm cervical dilation
Regular contractions
Progresses at 1cm per hour

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6
Q

What is the transition phase of the first stage of labour?

A

From 7 to 10cm cervical dilation
Strong regular contractions
Progresses at 1cm per hour

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7
Q

What are Braxton-Hicks contractions?

A

Occassional irregular contractions that can be felt during the second and third trimesters of pregnancy. They do not progress or become regular

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8
Q

What are the signs of labour?

A

Mucus plug from the cervix
Rupture of membranes
Regular, painful contractions
Dilating cervix on examination

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9
Q

What is rupture of membranes (ROM)?

A

When the amniotic sac has ruptured

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10
Q

What is spontaneous ROM?

A

The amniotic sac has ruptured spontaneously

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11
Q

What is pre-labour ROM?

A

The amniotic sac has ruptured before the onset of labour

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12
Q

What is preterm pre-labour ROM?

A

The amniotic sac has ruptured before the onset of labour and before 37 weeks gestation

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13
Q

What is prolonged ROM?

A

The amniotic sac ruptures more than 18 hours before delivery

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14
Q

What is the definition of prematurity?

A

Delivery before 37 weeks gestation

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15
Q

What is cardiotocography?

A

Used to measure fetal heart rate and contractions of the uterus

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16
Q

How is CTG recorded?

A

Two doppler ultrasound transducers are placed on the abdomen:
- One above the fetal heart
- One above the fundus of the uterus

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17
Q

What are the indications for continuous CTG monitoring?

A

Sepsis
Maternal tachycardia
Significant meconium
Pre-eclampsia
Fresh antepartum haemorrhage
Delay in labour
Use of oxytocin
Disproportionate maternal pain

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18
Q

What are the 5 key features of CTG?

A

Contractions
Baseline fetal heart rate
Variability
Accelerations
Decelerations

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19
Q

What is a reassuring baseline fetal heart rate?

A

110-160

20
Q

What is a non-reassuring baseline fetal heart rate?

A

100-109 or 161-180

21
Q

What is an abnormal fetal heart rate?

A

Below 100 or above 180

22
Q

What is normal variability of fetal heart rate?

A

5-25

23
Q

What is a non-reassuring variability of fetal heartrate?

A

Less than 5 for 30-50 minutes or more than 25 for 15-25 minutes

24
Q

What is an abnormal variability of fetal heartrate?

A

Less than 5 for over 50 minutes or more than 25 for over 25 minutes

25
Q

What are decelerations?

A

Fetal heartrate dropping in response to hypoxia

26
Q

What are early decelerations?

A

Dips and recoveries in heart rate that correspond with uterine contractions - they are normal

27
Q

What are late decelerations?

A

Gradual falls in heart rate that start after the contraction has began. They are caused by hypoxia in the fetus and are pathological

28
Q

What are variable decelerations?

A

Decelerations that may be unrelated to uterine contraction. They are related to compression of the umbilical cord

29
Q

What are prolonged decelerations?

A

A drop of more than 15bpm from baseline that lasts between 2 and 10 minutes

30
Q

What is progress in labour influenced by?

A

Power - uterine contractions
Passenger - size, presentation and position of baby
Passage - size and shape of pelvis

31
Q

What is failure to progress in the first stage of labour?

A

Less than 2cm of cervical dilation in 4 hours
Slowing of progress in a multiparous woman

32
Q

What is a partogram?

A

Monitoring system during the first stage of labour

33
Q

What is the attitude of the fetus?

A

The posture of the fetus

33
Q

What is included in a partogram?

A

Cervical dilation
Descent of fetal head
Maternal pulse, BP, temp and urine output
Fetal heart rate
Frequency of contractions
Status of the membranes
Drugs and fluids that have been given

33
Q

What is failure to progress in the second stage of labour?

A

When the active (pushing) phase of the second stage lasts more than 2 hours in a nulliparous woman or 1 hour in a multiparous woman

34
Q

What is oblique lie?

A

The fetus is at an angle

34
Q

What is longitudinal lie?

A

The fetus is straight up and down

35
Q

What is cephalic presentation?

A

The head presents first

35
Q

What is transverse lie?

A

The fetus is straight side to side

36
Q

What is shoulder presentation?

A

The shoulder presents first

37
Q

What is a complete breech presentation?

A

Breech presentation (feet first) with hips and knees flexed

38
Q

What is a frank breech presentation?

A

A breech presentation with hips flexed and knees extended - bottom first

39
Q

What is a footling breech?

A

A breech presentation with a foot hanging through the cervix

40
Q

What is delay in the third stage of labour?

A

More than 30 minutes with active management
More than 60 minutes with physiological management

41
Q

What is the management of failure to progress in labour?

A

ARM - artifical rupture of membranes
Oxytocin infusion
Instrumental delivery
C-section

42
Q

What is active management of the third stage of labour?

A

When the doctor/midwife assists in the delivery of the baby

43
Q

How is the third stage of labour actively managed?

A

IM oxytocin after delivery of the baby

Obstetrics (32 decks)

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