Labour

Question 1

What are the 3 stages of labour?

Answer 1

stage 1: from the onset of true labour to when the cervix is fully dilated
stage 2: from full dilation to delivery of the fetus
stage 3: from delivery of fetus to when the placenta and membranes have been completely delivered

Question 2

What is monitored in labour?

Answer 2

FHR monitored every 15min (or continuously via CTG)
Contractions assessed every 30min
Maternal pulse rate assessed every 60min
Maternal BP and temp should be checked every 4 hours
VE should be offered every 4 hours to check progression of labour
Maternal urine should be checked for ketones and protein every 4 hours

Question 3

What are the parts of the first stage of labour?

Answer 3

latent phase = 0-3 cm dilation, normally takes 6 hours
active phase = 3-10 cm dilation, normally 1cm/hr

Question 4

How long does the first stage of labour last in a primigravida woman?

Answer 4

10-16 hours

Question 5

How does the baby present in the first stage of labour?

Answer 5

90% are vertex. Head enters pelvis in occipito-lateral position. The head normally delivers in an occipito-anterior position.

Question 6

How long does the second stage of labour take and what constitutes delay?

Answer 6

Lasts 1 hour usually. If >1 in multiparous and >2 in nulliparous, delayed labour.

Ventouse extraction, forceps delivery or caesarean section.
Episiotomy may be necessary following crowning.
Associated with transient fetal bradycardia.

Question 7

What are indications for a forceps delivery?

Answer 7

fetal distress in the second stage of labour
maternal distress in the second stage of labour
failure to progress in the second stage of labour
control of head in breech deliver