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WEEK 3 SEM 4 > Labour > Flashcards

Labour Flashcards

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1
Q

When is labour diagnosed?

A
  • regular and increasing uterine contractions

- bring about cervical effacement and/or dilation

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2
Q

What is cervical effacement?

A

cervical thinning
shortening of cervix
cervix pulls up into the uterus
becomes part of lower uterine wall

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3
Q

How many stages of labour are there?

A

3

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4
Q

What happens in the first stage of labour?

A

Period between regular uterine contraction and full dilation of the cervix

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5
Q

What happens in the second stage of labour?

A

Full cervical dilation (10cm) to delivery of the foetus

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6
Q

How long is the 2nd stage normally in a nulliparous woman (someone who has never given birth)?

A

1 hour

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7
Q

How long is the 2nd stage normally in a multiparous woman (someone who has given birth before)?

A

half an hour

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8
Q

What happens in the third stage of labour?

A

Period between the delivery of the foetus to the delivery of the placenta and amniotic membranes

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9
Q

How long does the 3rd stage normally last?

A

less than 15 minutes with active management

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10
Q

The first stage of labour has 2 phases. What are they?

A

latent phase

active phase

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11
Q

What happens in the latent phase of the first stage of labour?

A
  • cervix becomes effaced (goes from 3cm long to less than 0.5cm long)
  • then dilates to 3cm
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12
Q

How long does the latent phase take?

A

With regular uterine contractions this takes:

6-8 hours= NULLIIPAROUS
4-6 hours= MULTIPAROUS

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13
Q

What happens in the active phase of the first phase of labour?

A
  • dilatation from 3cm to 10cm

- rate of cervical dilation on average is about 1cm/hour

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14
Q

What is a partogram?

A

graphic representation of the progress of labour

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15
Q

What does a partogram record?

A
  • rate of cervical dilatation
  • descent of the head
  • contraction frequency and duration
  • foetal heart rate
  • colour and quantity of liquor (this is the amniotic fluid)
  • maternal pulse, blood pressure, temperature, urine output and it’s analysis
  • caput and moulding of the baby’s skull
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16
Q

What is a caput?

A

swelling that can be felt on the foetal skull

17
Q

What is moulding?

A

overlapping of the skull bones= allows foetus head to move through the cervix

18
Q

How does moulding happen?

A
  • sutures of baby’s skull are not flexible at birth
  • so skull bones can overlap - make the skull smaller
  • normal in childbirth
19
Q

On the partogram, there are 2 lines to show cervical dilation. What are they called?

A

alert line

action line

20
Q

What is the alert line?

A

drawn at a rate of 1cm/hour

21
Q

What is the action line?

A

line drawn 2-3cm to right of alert line (parallel to alert line)

22
Q

When is the first point plotted on the alert line?

A

when the mother first reaches active phase of labour

i. e.
- if a woman admits herself into the hospital with 5cm dilatation of the cervix, the first plot will be done on the 5cm mark on the alert line

23
Q

How often do you take readings of cervical dilation?

A

every 1-4 hours

24
Q

What does the alert and action line mean?

A

if points are plotted on the alert line, means the progression to labour is fine

  • if plotting goes to the right of action line, then labour is seen as slow and need action to be taken
25
Q

What are causes of slow labour?

A

PASSAGE- pelvis not big enough for baby to come through

PASSENGER- the foetus might be fat or exit of cervix is suboptimal diameter (foteus may be the wrong way round)

POWER- uterine contractions are not enough

26
Q

What is seen when admitting a woman in labour?

A
  1. assessment
    - check if pregnancy is high or low risk
  2. definitive diagnosis of labour
    - this can be hard bc you need to keep observing
  3. discuss action plan with mother that needs to be adhered to
  4. consult with consultant when required
27
Q

How do you manage a slow latent phase?

A
  • reassure mother that this is normal
  • keep mother nourished, hydrated and offer pain relief
  • keep an eye on mother and foetus through appropriate surveillance (e.g. foetal heart sounds)
  • allow labour to progress naturally
  • actively manage mother and foetus if there are any complications
28
Q

What are the complications of slow labour?

A
  • Maternal dehydration or exhaustion
  • Maternal and foetal infection
  • Foetal distress
  • Operative delivery ie a caesarian section
  • Uterine rupture
  • Haemorrhage ie bleeding after the delivery
  • Increased maternal and foetal morbidity
  • Increased chance of a vesicovaginal fistula
29
Q

What is a vesicovaginal fistula?

A
  • when prolonged labour
  • baby pushes vesicovaginal wall for too long
    (wall vetween vagina and bladder)
  • so tissue loses its blood supply
  • becomes necrotic
  • leaves a hole
  • urine then leaks from the bladder into the vagina

WEEK 3 SEM 4 (6 decks)

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