Labour Flashcards

1
Q

Define term

A

37-41 weeks

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2
Q

Define pre and very pre term delivery

A

premature= 22-37 weeks

very premature= 28-32

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3
Q

what are the key tissues involved in labour?

A

Cervix
myometrium
fetal membranes

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4
Q

What are the key stages of labour?

A
Cervical ripening and enffacement
coordinated myometrial contraction
Rupture of fetal membranes
Delivery of the infant
Delivery of the placenta
contraction of the uterus
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5
Q

How long do the three phases of labour last

A

Phase 1- contractions 12-48hrs
Phase 2 Delivery of the baby- a few hours
Phase 3 Delivery of the placenta - 30 minuets

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6
Q

Describe cervical ripening and effacement

A

Change of cervix from rigid to flexible, remodelling of ECM, leucocyte recruitment (mainly neutrophils). Inflammatory changes (PgE2, IL8 paracrine)

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7
Q

What causes water breaking

A

Rupture of the fetal membrain due to changes in amnion basement component, inflam and leucocytes, increased MMPS.

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8
Q

What mediates myometrial contractions?

A

PgF2a and PgE2 from fetal membrane, oxytocin recptor and contraction associated proteins.

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9
Q

What binding domain can be found in most pro labour genes

A

NFkB

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10
Q

What do ‘we’ think intiates term labour?

A

PAF- produced in the lungs (indicates fetal maturity)
CRH- produced by the placenta

Note both cause an increase in IL1B, pgE2, COX

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11
Q

What can predispose the initiation of labour

A

Anything that can increase CRH. Eg

multiple pregnancies, stress, infection.

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12
Q

What reduces the blood lost from spiral arteries

A

Strong uterine contractions during placental delivery as the spiral arteries cannot constrict to limit it.

also involution post placental delivery (oxcytocin mediated)

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13
Q

What accelerates cervical dilation?

A

Increased strength and frequency of contractions, forces the fetal head to put pressure of the cervix.

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14
Q

When do progesterone levels drop

A

Post placental delivery, before would lead to the end of pregnancy.

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15
Q

Why does labour occur when progesterone levels are still high?

A

At term more progesterone A is produced than B

progesterone B is the form that mediates the main effects of progesterone.

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