Labour

Question 1

What hormone stimulates contractions?

Answer 1

Oestrogen.

Question 2

What hormones increases the uterine contractions?

Answer 2

Prostaglandins.

Question 3

Think P and P,

Answer 3

Progesterone Prevents labour.

Question 4

What is the best position for a baby to be in ?

Answer 4

Left occipito anterior.

Question 5

What is stage 1 of labour?

Answer 5

Onset of labour to full dilatation.

Question 6

Latent phase of stage 1?

Answer 6

0-4cm.

Question 7

Active phase of stage 1?

Answer 7

4-10cm.

Question 8

Maximal accepted time from full dilatation to delivery for a nulliparous with with analgesia?

Answer 8

3 hours.

Question 9

Maximal time from full dilatation to delivery fora multiparous woman w/o anaesthesia?

Answer 9

1 hour.

Question 10

When should ergometrine not be used for management of the 3rd stage of labour/.

Answer 10

Contraindicated if there is a history of hypertension due to the risk of stroke.

Question 11

Cardinal movements in labour:

Answer 11

B1) Head engages in LOA position.

2) As the head descends, there is flexion and internal rotation from LOA to OA.
3) Extension then begins as the head goes through the cervix.
4) Full extension is reached by the time the head is at the vaginal opening.
5) One the head is deliverered, there is restitution.
- Restiution is external rotation back to LOA so that the shoulder can be delivered.

Question 12

How is the cervix scored?

Answer 12

By using the Bishop score.

Question 13

A Bishop score of < 5 suggests what?

Answer 13

Suggests that labour is unlikely to begin therefore you should induce.

Question 14

A Bishop score of > 9

Answer 14

Means that labour is likely.

Question 15

When should a CTG be initiated?

Answer 15

Maternal request. 
Risk factors for foetal distress
Meconium staining 
Abnormal HR on ausculastation 
Fresh vag bleeding.,
Augmentation of contractions with syntocicinon .

Question 16

What layers are cut though during a CS?

Answer 16

Superficial fascia. 
Deep fascia. 
Recurs sheath/ rectus abomininus
Transversalis fascia. 
Peritoneum, 
Uterus

Question 17

Options for pain relief in labour?

Answer 17

Massage, aromatherapy, water birth.

Entonox.

Opiates (pethidine or diamoprhine)

Epidural (LA/opioid mix)

Question 18

Side effects of epidural?

Answer 18

Onset is 20-30mins and can be topped up as labour continues.

Disadvantage:

• Slows 2nd stage of labour.
• Increases the chance of a malpresentation.
• increases risk of op delivery; NOT c section.
• mother should not lie flat as this increases aorta-cabal compression.
• maternal SEs are headache, urinary retention. Hypotension.

Question 19

What level is a pudendal nerve block?

Answer 19

S2-S4, move 2 finger breadths lateral to ischial spines.