LABOUR Flashcards

1
Q

4 P’s of slow progress in labour

A

Power
passage
patient
passanger

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2
Q

explain passage

A
  • issue with soft tissues of birth canal (cervix, vagina, pelvic floor, perineum)
  • CPD
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3
Q

mechanisms of labour In Occipito-Anterior or Lateral Cases these are

A

In Occipito-Anterior or Lateral Cases these are:

  1. Descent and further flexion of the head.
  2. Internal rotation of head (to OA)
  3. Extension and delivery of head
  4. Restitution and external rotation
  5. Delivery of anterior and posterior shoulder by lateral flexion
  6. Delivery of trunk, buttocks and legs
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4
Q

explain power component

A

adequate contractions = 3-4 strong contractions in 10 minutes.
Powers- Inadequate contractions (dysfunctional labour)
- poor dilatation, effacement, descent of the fetus
- Often inadequate contractions in primigravida
- establish stronger contactions by surgical or manual rupturing membranes and giving augmentaion with IV Oxytocin
- Reassess in 2hrs
- If no further progress deliver by c/s

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5
Q

explain patient component

A
  • Illness
  • Full bladder
  • Exhaustion
  • Mobility
  • Positioning
  • Companion
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6
Q

explain passenger component

A
  • macrosomia
  • Abnormal presentation or position
  • Fetal abnormality e.g hydrocephalus
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7
Q

signs of placenta separation

A
  • PV bleeding
  • A rise in the fundal height
  • fundus becomes globular and firm
  • lengthening of the umbilical cord
  • traction upwards of the fundus fails to draw the cord with it
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8
Q

mechanisms of labour

A
  1. Descent and engagement
  2. Flexion
  3. Internal rotation
  4. Crowning and extension
  5. Restitution and external rotation
  6. Lateral flexion: birth of the anterior shoulder followed by the posterior shoulder
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