Labour Flashcards
What is the 1st stage of labour divided into
Latent phase
Established Phase
Describe the latent phase of 1st stage labour
Painful, often irregular contractions
Some cervical effacement
Some dilation up to 4cm
Describe the established phase of 1st stage labour
Regular contractions
Progressive effacement
Cervical dilation from 4-10cm
What is the satisfactory rate of cervical dilation in established labour
0.5-1cm/hr
How often should the cervix be checked during labour
Every 4 hrs
What are the 2 phases of 2nd stage labour
Passive phase
Active phase
What is the passive phase of 2nd stage labour
when cervix are fully dilated (10cm)
Absence of involuntary expulsive contractions
How long should a women be in passive 2nd stage labour for
1hr
What is the purpose of passive phase of 2nd stage labour
To allow for further feral descent
What is the active phase of 2nd stage labour
Pushing phase
Mother pushes using valsalva manoeuvre and abdominal muscles
Which medication should be given for augmentation of labour
Oxytocin
What should the delay be in clamping the cord in a premature baby and why
3min
To decrease risk fo anaemia
What should the delay be in clamping the cord in a full term baby
1min
Where does 1st stage labour begin and end
Begins with regular contractions
Ends at full dilation of cervix
Where does 2nd stage labour begin and end
Begins at full cervical dilation
Ends at delivery of fetes
Where does 3rd stage labour begin and end
Beings at the delivery of the foetus
Ends at the delivery of the placenta and fetal membranes
What is 3rds stage labour
The delivery of the placenta and membranes
What is physiological management of thirst stage labour
No use of uterotonic drugs
No clamping of the cord until pulsation has stopped Delivery of placenta by maternal efforts
How quickly from the beginning of active 2nd stage would you expect delivery from a primigravida
2hrs
How quickly from the beginning of active 2nd stage labour would you expect delivery from a multigravida
1hr
Components of active management of 3rd stage labour
Use of uterotonic drugs
Early clamping of cord
Controlled cord traction after signs of placenta separation
Which uterotonic drugs are given in active management of 3rd stage
Ergometrine
Oxytocin
When is prolonged 3rd stage labour Dx in active management
After 30mins
When is prolonged 3rd stage labour Dx in physiological management
After 60 mins
Steps of the mechanism of labour
Descent Flexion Internal rotation of the head Crowning and extension of the head Restitution Internal rotation of the shoulders External rotation of the head Lateral flexion
