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Biology > Labour > Flashcards

Labour Flashcards

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1
Q

What is the active phase?

A

This period is characterised by regular painful uterine contractions and substantial degree of cervical effacement until it becomes incorporated into the lower uterine segment and more rapid dilation leading from the 5cm to fully dilated- 10cm. It may last 12-14 hours in primigravidae but tends to be shorter in multigravida

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2
Q

Average time of labour in multiparous?

A

6-10 hours

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3
Q

Average time of labour in primiparous

A

12-14 hours

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4
Q

What is Latent Phase?

A

This period is characterised by painful uterine contractions and variable changes of the cervix including some degree of the cervix and slow progression of dilation up to 5 cm.

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5
Q

What do contractions do?

A

Ideally should occur 37 weeks gestation
Contractions are involuntary, regular and intermittent-Coordinated uterine contractions exerts a steady pull thus stretching the cervix

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6
Q

How can we increase contractions?

A

Frequency and the strengths of the contractions can be increased by enemas (a procedure in which liquid or gas is injected into the rectum), prostaglandins and oxytocin and by the stretching of the cervix.

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7
Q

What is ischaemia ?

A

ischaemia (restriction in blood supply to tissues, causing a shortage of oxygen) in the muscles during the contractions because blood vessels in the uterus are compressed.

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8
Q

What are the names for Normal and Abnormal labour?

A

NORMAL LABOUR: EUTOCIA

ABNORMAL LABOUR: DYSTOCIA

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9
Q

What is the weight of the uterus before and after pregnancy?

A

Non-pregnant uterus:50-70 g
Pregnant uterus: 800-1200 g

The non-pregnant uterus is a hollow, muscular, pear-shaped organ. It is 7.5 cm long, 5 cm wide and 2.5 cm in depth, each wall being 1.25 cm thick.

The pregnant uterus measures 38 cm in length and 24 to 26 cm in width.

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10
Q

What is incoordinated uterine activity

A

INCOORDINATE UTERINE ACTIVITY- if wave pattern is abnormal, labour does not progress efficiently.

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11
Q

Oxytocin in pregnancy

A

synthesised in the hypothalamus and released from the posterior pituitary gland.

Once released from the pituitary gland, oxytocin travels through the bloodstream creating the muscles of the uterus to contract.

production of oxytocin are very low and stay at one level most of the time before labour. However, once the first stage of labour has commenced oxytocin levels increase.

Oestrogen and prostaglandins increase uterine responsiveness to oxytocin.

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12
Q

What are Braxton Hicks?

A

Braxton Hicks which a painless and irregular contractions, help blood flow to the placenta

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13
Q

Role of Amniotic fluid?

A

important role in protecting the fetus from external impact

Allows symmetrical fetal growth and movement.

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14
Q

What is the fetal axis pressure?

A

During each contraction the uterus rises forward and the force of the fundal contraction is transmitted to the upper pole of the fetus down the long axis of the fetus and applied by the presenting part to the cervix.

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15
Q

Occiput anterior position

A

The left occiput anterior (LOA) position is the most common in labor. In this position, the baby’s head is slightly off center in the pelvis with the back of the head toward the mother’s left thigh.

The right occiput anterior (ROA) presentation is also common in labor. In this position, the back of the baby is slightly off center in the pelvis with the back of the head toward the mother’s right thigh.

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16
Q

Transverse position

A

Left Occiput Transverse (LOT)

When facing out toward the mother’s right thigh, the baby is said to be left occiput transverse (LOT). This position is halfway between a posterior and anterior position. If the baby was previously in a posterior position (in either direction), the LOT position indicates positive movement toward an anterior position.

Right Occiput Transverse (ROT)
When the baby is facing outward toward the mother’s left thigh, the baby is said to be right occiput transverse (ROT). Like the previous presentation, ROT is halfway between a posterior and anterior position. If the baby was previously in a posterior position, ROT is a sign the baby is making a positive move toward an anterior position

17
Q

Occiput posterior position

A

Right Occiput Posterior (ROP)
In the right occiput posterior position (ROP), the baby is facing forward and slightly to the right (looking toward the mother’s left thigh). This presentation may slow labor and cause more pain.

Left Occiput Posterior (LOP)
When facing forward, the baby is in the occiput posterior position. If the baby is facing forward and slightly to the left (looking toward the mother’s right thigh) it is in the left occiput posterior (LOP) position. This presentation can lead to more back pain (sometimes referred to as “back labor”) and slow progression of labor

18
Q

Rupture of membranes

A

Fetal membrane rupture occurs when the contraction of the uterus causes the presenting part to distend them.
There is a loss of lubricant between the chorion and amnion which leads to a cell rupture.

19
Q

Average time of 2nd stage for multiparous and primiparous

A

Average time in multiparous: 30 minutes

Average time in primiparous: 60 minutes

20
Q

What is the Ferguson Reflex ?

A

The Ferguson Reflex → e.g of positive feedback
Oxytocin results in increasing contractions as the presenting part of the fetus stimulates nerve receptors in the pelvic floor.

21
Q

What changes occur to uterine contractions in 2nd stage?

A

Become stronger and longer but may be less frequent allowing both mother and fetus regular recovery period.

22
Q

What is curvature of Carus?

A

Amniotic fluid escapes and fetus undergoes a pattern of movements as it follows the shape and curve of the pelvis → curvature of Carus.

23
Q

What is crowning?

A

Crowning: when the widest part of the head distends the vulva.

24
Q

Mechanism of labour?

A

Fetal head passes through the pelvis creating pressure on the sacral nerves and may be associated with cramps in the legs.
Fetus distends the vagina and displaces the pelvic floor.
Urethra elongates and become compressed → bladder is repositioned
Rectum is compressed which can cause defecation
Perineum is flattened and lengthened by the fetus
During contraction the fetal head moves forward however during intervals of the contraction, the presenting part recedes slightly.

25
Q

What is Lateral flexion?

A

Lateral flexion is the bending of the neck or body toward the right or left side.

26
Q

What is placenta separation?

A

The placenta separates from the wall of the uterus and is expelled.
takes around 30 minutes- 1 hour: if delayed, women may not have a haemorrhage because placenta is still attached.
The woman should be encouraged to sit upright and have an empty bladder as this can stop the uterus from contracting because the bladder will be full.
Skin-to-skin contact is also encouraged because oxytocin could be released.
After delivery, the uterus decreases in size which allows the detachment of the placenta.

27
Q

What are the signs of placenta separation?

A

Tender and hard uterus
Lengthening of the cord
Trickle of blood

28
Q

What is the Schultze Method?

A

This type of separation starts in the centre of the placenta which descends first.
Fetal surface appears at the vulva
Retroplacental clot is contained within the inverted sac- min blood loss

29
Q

What is the Matthew Duncan Method?

A

Less common separation and starts the lower edge of the placenta
Placenta slips down sideways
Maternal surface appears first at the vulva
Retroplacental clot does not form
Bleeding is likely to profuse

30
Q

Delayed cord clamping

A

It is important that the baby is still getting nutrients and oxygen from the placenta
At least 5 minutes
Blood transfusion

31
Q

Uterine muscle-living ligatures

A 
Progressively shortening muscle fibres tighten around the maternal vessels and prevent blood flow.
3 layers of muscle in the uterus:
Longitudinal
Circular
Oblique
32
Q

Types of managment in 3rd stage

A

ACTIVE
Involves the injection of an anti-tocolytic agent.
Syntometrine: a combination of oxytocin and ergometrine which is used to prevent PPH.
PHYSIOLOGICAL
No drugs
No clamping of the cord.

33
Q

Define hypertrophy and hyperplasia.

A

Hypertrophy: The hypertrophy is an increase of the volume of a given tissue or organ due only to the enlargement of the cells.
Hyperplasia: The hyperplasia is an increase in the amount of a tissue, resulting from cell proliferation.

Biology (25 decks)

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