Labour and Delivery

Question 1

When do labour and delivery normally occur?

Answer 1

Between 37 and 42 weeks gestation

Question 2

How many stages of labour are there?

Answer 2

3

Question 3

What is the first stage of labour?

Answer 3

From the onset of labour (true contractions) until 10cm cervical dilation.

Question 4

What is the second stage of labour?

Answer 4

From 10cm cervical dilation to delivery of the baby.

Question 5

What is the third stage of labour?

Answer 5

From delivery of the baby to delivery of the placenta.

Question 6

What is the role of prostaglandins in labour?

Answer 6

Stimulate contraction of uterine muscles.

Ripening the cervix before delivery.

Question 7

Name a key prostaglandin in labour.

Answer 7

Prostaglandin E2

Question 8

What types of pessaries can be used to induce labour?

Answer 8

Pessaries containing prostaglandin E2 (dinoprostone).

Question 9

What are Braxton-Hicks contractions?

Answer 9

Occasional irregular contractions of the uterus.

Women can experience temporary and irregular tightening or mild cramping in the abdomen.

These are not true contractions, and they do not indicate the onset of labour. They do not progress or become regular.

Question 10

When are Braxton-Hicks contractions usually felt?

Answer 10

Second and third trimester

Question 11

How can Braxton-Hicks contractions be reduced?

Answer 11

Staying hydrated and relaxing

Question 12

What is cervical effacement?

Answer 12

When the cervix gets thinner from front to back (during first stage of labour)

Question 13

What is the “show”?

Answer 13

Mucus plug in the cervix, that prevents bacteria from entering the uterus during pregnancy, falling out and creating space for the baby to pass through.

Question 14

What are the 3 phases of the first stage of labour?

Answer 14

1. Latent phase
2. Active phase
3. Transition phase

Question 15

What is the latent phase of the first stage of labour?

Answer 15

From 0 to 3cm dilation.

Question 16

How quickly does the latent phase of first stage of labour progress?

Answer 16

~0.5cm per hour

Question 17

Are contractions during latent phase of first stage of labour regular or irregular?

Answer 17

Irregular

Question 18

What is the active phase of the first stage of labour?

Answer 18

From 3cm to 7cm dilation.

Question 19

How quickly does the active phase of first stage of labour progress?

Answer 19

1cm per hour

Question 20

Are contractions during active phase of first stage of labour regular or irregular?

Answer 20

Regular

Question 21

What is the transition phase of the first stage of labour?

Answer 21

From 7cm to 10cm dilation.

Question 22

How quickly does the transition phase of first stage of labour progress?

Answer 22

1cm per hour.

Question 23

Are contractions during transition phase of first stage of labour regular or irregular?

Answer 23

Strong and regular

Question 24

What does the success of the second stage of labour depend on?

Answer 24

1. Power (strength of uterine contractions)
2. Passenger (qualities of foetus)
3. Passage (pelvis)

Question 25

What are the 4 important qualities of the foetus during the second stage of labour?

Answer 25

1. Size (esp. head)
2. Attitude (posture)
3. Lie (position in relation to mother’s body)
4. Presentation (part closest to cervix)

Question 26

What does longitudinal lie mean?

Answer 26

Foetus is straight up and down

Question 27

What does transverse lie mean?

Answer 27

Foetus is straight side to side

Question 28

What does oblique lie mean?

Answer 28

Foetus is at an angle

Question 29

What does cephalic presentation mean?

Answer 29

Foetus presents head first

Question 30

What does shoulder presentation mean?

Answer 30

Foetus presents shoulder first

Question 31

What does breech presentation mean?

Answer 31

Legs are first

Question 32

What are the three types of breech presentation?

Answer 32

1. Complete breech
2. Frank breech
3. Footling breech

Question 33

What is complete breech?

Answer 33

Hips and knees flexed (like doing a cannonball jump into a pool)

Question 34

What is frank breech?

Answer 34

Hips flexes and knees extended, bottom first

Question 35

What is footling breech?

Answer 35

Foot hanging through the cervix

Question 36

What are the 7 cardinal movements of labour?

Answer 36

1. Engagement
2. Descent
3. Flexion
4. Internal rotation
5. Extension
6. Restitution and external rotation
7. Expulsion

Question 37

What landmark do obstetricians describe the positions of the baby’s head during the descent phase?

Answer 37

Ischial spines

Question 38

What does -5 indicate when measuring descent?

Answer 38

Baby is high up at around the pelvic inlet

Question 39

What does 0 indicate when measuring descent?

Answer 39

Head is at ischial spines (i.e. engaged)

Question 40

What does +5 indicate when measuring descent

Answer 40

Head has descended further out beyond ischial spines

Question 41

What does physiological management of the third stage of labour mean?

Answer 41

Placenta is delivered by maternal effort without medications or cord traction.

Question 42

What does active management of the third stage of labour mean?

Answer 42

Where the midwife or doctor assist in delivery of the placenta.

Question 43

When is active management of the third stage of labour indicated?

Answer 43

Haemorrhage or more than a 60-minute delay in the delivery of the placenta.

Question 44

What side effects may active management of the third stage of labour be associated with?

Answer 44

Nausea and vomiting

Question 45

How is the third stage of labour actively managed?

Answer 45

Intramuscular oxytocin to help the uterus contract and expel the placenta. Careful traction is applied to the umbilical cord to guide the placenta out of the uterus and vagina.