labour and birth Flashcards
what is a normal labour ?
spontaneous labour that occurs between 37 and 42 weeks of gestation, with a single cephalic, term healthy, live fetus with no maternal or fetal complications
what is the duration of a normal labour in primigravida vs multigravida ?
primigravida: 12-18 hours
multigravida: 6-10 hours
what is a precipitate labour ?
an unusually rapid labour ( combined first and second stage of labour)
what are the physiological changes that happen prior to the onset of labour ?
- increased oxytocin and prostaglandins
- formation of gap junctions between myometrial cells
- formation of lower uterine segment
- increased myometrial tone with irregular contractions
- cervical softening ( effacement and dilatation)
what are the suggested theories about the inset of labour ?
decrease in progesterone levels decrease in oxytocinase levels uterine distention increase in prostaglandin levels increase in fetal cortisone
how can we distinguish false labour pains ?
braxton hicks contractions are irregular , infrequent and there is no cervical dilatation associated with it
how can we distinguish true labour pains from false labour pains ?
true labour pains do not go away with analgesia or sleep
true labour pains are more frequent, more regular and more intense in strength and is associated with cervical dilatation
how many stages of labour are there ?
three main stages
what is the first stage of labour ?
full cervical dilatation
what are the different stages in the first stage of labour ?
latent phase
accelerated phase
how long does the first stage of labour last in primigravida and multi women ?
prima- 18 hrs
multi- 6-10 hrs
what is the difference between the latent phase and the accelerated phase in the first stage of labour ?
latent phase refers to the gradual dilatation of the cervix until 4 cms
the active phase refers to the accelerated dilatation of the cervix from 4cm to 10 cms
why is the duration of the first stage of labour shorter inn multi women ?
effacement and dilatation of the cervix happen simultaneously
what is the normal rate of dilatation of the cervix in multi women vs prima women ?
- 2 cm per hour in prima
1. 5 cm per hour in multi
what is the most common presentation of delivery in foetuses ?
cephalic presentation
what does vertex mean ?
when the baby lies in an attitude of flexion the part of the head presenting is called the vertex
what diameters are present in a cephalic vertex presentation ?
biparietal 9.5 cm
subocciptobregmatic 9.5 cm
what is the second stage of labour ?
expulsion of the fetus ( which is refers to the full dilatation of the cervix to the birth of the baby )
how long does the second stage of labour last in prima and in multi ?
prima - 2 hours max
multi - 1 hour max
provided the woman has efficient uterine contractions
what are efficient uterine contractions ?
3 contractions every 10 minutes each lasting one minute
what is the difference between the passive and active stages of the second stage of labour ?
- the passive stage is from finding of the full dilatation of the cervix but before or in absence of involuntary contractions
- the active stage the baby is visible and expulsion contractions are present
how is the patient instructed to strain/bear down ?
they are asked to strain with their uterine contractions and to relax in between
what are the stages of fetal expulsion in order ?
- descend
- engagement
- increased flexion
- internal rotation of the head
- extension
- restitution
- external rotation of the head / internal rotation of the shoulders
in what stage is delivery seen ?
in the extension part
