Labour Flashcards
What is the cervix dilation during 1st stage of labour? How quickly is it progressing?
- Cervix dilation of 4-10 cm
- Progression of 0.5cm per hour
When is the cervix fully dilated?
10cm
What is the cervix dilation during second stage of labour? How soon after is the baby expected?
Fully dilated until delivery
Expected within 2-3 hours
When is the 3rd stage of labour?
From delivery of baby until delivery of placenta
How soon after delivery of baby is delivery of placenta expected?
Within 1 hour
What are the cardinal movements of labour?
Changes in the position of the foetus’s head during its passage in labor.
Describe the cardinal movements?
- Head floating, before engagement
- Engagement; descent, flexion
- Further descent, internal rotation
- Complete rotation, beginning extension
- Complete extension
- Restitution (external rotation)
- Delivery of anterior shoulder
- Delivery of posterior shoulder
What must you check for during crowning?
Nuchal cord
What are the 3 P’s that can categorise abnormal labour?
- Passenger
- Power
- Passage
What does ‘passenger’ refer to?
Size / position / distressed / multiple
What does ‘power’ refer to?
Uterine contractions e.g. inadequate contractions
What does ‘passage’ refer to?
Pelvic dimensions
What forceps can be used for delivery?
- Neville-Barnes
- Keillands
- Ventouse
What is a breech delivery?
Baby lying bottom or feet first
What is a safer way to deliver a breeched baby?
C-section
What are two non-pharmacological types of pain relief commonly used in labour ?
- TENS
2. Water birth
What is TENS?
TENS is a drug-free kind of pain relief often used by women in the early stages of labour. TENS stands for Transcutaneous Electrical Nerve Stimulation.
A maternity TENS machine consists of a battery-powered, hand-held controller connected by fine leads to four flat pads. The pads are covered in a firm gel that helps them stick to your back.
The machine sends small, safe pulses of electrical current via the leads to the pads on your skin. The pulses pass through your skin and into your muscles and tissues. This gives you a gentle tingling or buzzing sensation, which may be stronger or weaker, depending on the setting level.
What are pharmacological types of pain relief used in labour?
- Oral
- Inhalation
- Injectable
What are regional types of pain relief used in labour?
- Spinal (most common)
- Epidural
- Combined
What is an epidural?
An injection in your back to provide pain relief
What is a spinal? How does it differ from an epidural?
Spinal uses a much smaller needle, directly into the cerebrospinal fluid that surrounds the spinal cord.
A spinal block is a single injection of local anaesthetic medications and so there is only one opportunity to deliver the medications. With an epidural, a catheter sits in an epidural space so drugs can be delivered as needed to extend the duration of the block.
When would general anaesthetic be used in labour?
- In an emergency
- If there’s a reason why a regional anaesthetic isn’t right for you, such as a blood clotting condition, infection or a back issue.
Why shouldn’t ibuprofen be used during pregnancy (after 30 weeks)?
Ibuprofen causes premature closure of the foetal ductus arteriosus –> can lead to a heart problem in your baby and a reduced amount of amniotic fluid.
What inhalational pharmacological agents are used for pain relief in labour?
Nitrous oxide:
- Entonox (50% NO, 50% O2): gas and air
What are side effects of inhalational agents?
Side effects include dizziness, nausea and amnesia
What opioids are used for severe pain in labour? What are side effects?
Diamorphine (NHS Heroin)
- Sedation
- Nausea and vomiting
- Respiratory depression
Pethidine (injection)
- Warning in epilepsy
What local techniques can be used to relieve pain during labour?
Perineal infiltration
Pudendal block
