Labour Flashcards
What hormone stimulates contractions?
Oestrogen.
What hormones increases the uterine contractions?
Prostaglandins.
Think P and P,
Progesterone Prevents labour.
What is the best position for a baby to be in ?
Left occipito anterior.
What is stage 1 of labour?
Onset of labour to full dilatation.
Latent phase of stage 1?
0-4cm.
Active phase of stage 1?
4-10cm.
Maximal accepted time from full dilatation to delivery for a nulliparous with with analgesia?
3 hours.
Maximal time from full dilatation to delivery fora multiparous woman w/o anaesthesia?
1 hour.
When should ergometrine not be used for management of the 3rd stage of labour/.
Contraindicated if there is a history of hypertension due to the risk of stroke.
Cardinal movements in labour:
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.
How is the cervix scored?
By using the Bishop score.
A Bishop score of < 5 suggests what?
Suggests that labour is unlikely to begin therefore you should induce.
A Bishop score of > 9
Means that labour is likely.
When should a CTG be initiated?
Maternal request. Risk factors for foetal distress Meconium staining Abnormal HR on ausculastation Fresh vag bleeding., Augmentation of contractions with syntocicinon .
What layers are cut though during a CS?
Superficial fascia. Deep fascia. Recurs sheath/ rectus abomininus Transversalis fascia. Peritoneum, Uterus
Options for pain relief in labour?
Massage, aromatherapy, water birth.
Entonox.
Opiates (pethidine or diamoprhine)
Epidural (LA/opioid mix)
Side effects of epidural?
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.
What level is a pudendal nerve block?
S2-S4, move 2 finger breadths lateral to ischial spines.
