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Reproductive System > Labour > Flashcards

Labour Flashcards

1
Q

What is parturition?

A

Transition from pregnant to non-pregnant state

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2
Q

What is labour?

A

Process by which a foetus is expelled from the uterus to the outside world

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3
Q

What is delivery?

A

Method of expulsion of the foetus

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4
Q

What are the purposes of contractions?

A

Dilation of the cervix

Pushing the foetus through the birth canal

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5
Q

How many stages of labour are there?

A

3

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6
Q

What is the first stage labour?

A

Creation of the birth canal

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7
Q

What is the clinical definition of the first stage of labour?

A

Interval between the onset of labour and full dilatation of the cervix

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8
Q

How is the first stage of labour divided?

A

Latent phase

Active phase

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9
Q

What is the latent phase?

A

Onset of labour with slow cervical dilation

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10
Q

What is the active phase?

A

Faster rate of change and regular contractions

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11
Q

What is the second stage of labour?

A

Delivery of foetus

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12
Q

What is the clinical definition of the second stage of labour?

A

Time between full dilatation of the cervix and delivery of the foetus

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13
Q

What are the 2 parts of the second stage of labour?

A

Passive

Active

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14
Q

What is passive labour?

A

Descent and rotation of the head

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15
Q

What is active labour?

A

Maternal effort to expel the foetus and achieve birth

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16
Q

What is the third stage of labour?

A

Expulsion of the placenta

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17
Q

What is the clinical definition of the third stage of labour?

A

Time between completed delivery of the baby and completed delivery of the placenta

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18
Q

How is labour initiated?

A

Prostaglandins promote cervix ripening

Increase in contractility of myometrium

  • increase in prostaglandins - increase calcium release
  • increase in oxytocin - lowers threshold for action potentials

Initiates uterine contractions

19
Q

What is cervix ripening?

A

Reduction in collagen
Increase in glycosaminoglycans
Increase in hyaluronic acid

20
Q

What is the effect of progesterone on labour?

A

Progesterone inhibits contractions

21
Q

What is the effect of oestrogen on labour?

A

Increases gap junctional communication between smooth muscle cells - increases contractility

22
Q

What are the borders of the birth canal?

A 
Posterior = sacral promontory 
Lateral = ilio-pectineal line 
Anterior = superior pubic rami
23
Q

What is special about the myometrium?

A

When they contract, they only partially relax so there is permanent shortening of the fibres

Forces foetus out of uterus

24
Q

What controls contractility?

A

Prostaglandins
- more Ca2+ per action potential

Oxytocin

  • more action potentials
  • lowers threshold
25
Q

What are the common foetal presentation descriptors?

A

Lie
Attitude
Presentation

26
Q

What is lie?

A

Relationship of long axis of foetus + uterus

27
Q

What are the different lie positions?

A

Longitudinal = foetus in position ready for birth

Transverse = foetus perpendicular to uterus

28
Q

What is attitude?

A

Posture of foetus during labour

29
Q

What is the normal attitude position?

A

Flexed

30
Q

What is foetal presentation?

A

Which part of the body is adjacent to the pelvic inlet

31
Q

What is the normal foetal presentation?

A

Head is first

32
Q

What is breech presentation?

A

Any other part is nearest pelvic inlet - commonly legs/bum

33
Q

How can labour be stimulated?

A

Membrane rupture - stimulates prostaglandin release
Artificial prostaglandins
Synthetic oxytocin
Anti-progesterone agents

34
Q

How can foetus physiology be monitored during birth?

A

Foetus monitoring

  • heart rate
  • movements

Maternal temp

Colour + amount of amniotic fluid

Scalp capillary pH

35
Q

What is the normal mechanism of labour?

A 
Foetus head flexes 
Head rotates internallu 
Crowning = head stretches the muscle + skin 
Head extended + externally rotates
Shoulders rotate 
Delivery
36
Q

How can delivery be assisted?

A

Instruments

  • forceps
  • vacuum

Caesarean section

37
Q

What is the risk of instrument delivery?

A

Nerve palsy

  • Erb’s palsy
  • Klumpke palsy
38
Q

What is Erb’s palsy?

A

Damage to upper part of brachial plexus (C5-7)

Elbow = extended 
Forearm = medially rotated + pronated
Wrist = weakly flexed
39
Q

What is Klumpke palsy?

A

Damage to lower part of brachial plexus (C8-T1)

Elbow = extended
Forearm = supinated 
Wrist = flexed
40
Q

How is the placenta delivered?

A

Placenta separated by uterine contractions
Powerful contraction - constrict the blood vessels
Blood clotting mechanism activated

41
Q

What stimulates the neonates first breath?

A

Trauma
Cold
Light
Noise

42
Q

What is the effect of the first breath?

A

Tissue resistance decreases in lungs
Vascular resistance increases - blood flows to lungs
Blood becomes oxygenated - pulmonary pO2 increases
Drop in pressure in RA - foramen ovale closes
Increased pO2 causes muscle walls to contract - ductus arteriosus closes

43
Q

What causes the ductus venosus to close?

A

Clamping the umbilical cord

Reproductive System (22 decks)

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