Labour and Delivery Flashcards
When do labour and delivery normally occur?
Between 37 and 42 weeks gestation
How many stages of labour are there?
3
What is the first stage of labour?
From the onset of labour (true contractions) until 10cm cervical dilation.
What is the second stage of labour?
From 10cm cervical dilation to delivery of the baby.
What is the third stage of labour?
From delivery of the baby to delivery of the placenta.
What is the role of prostaglandins in labour?
Stimulate contraction of uterine muscles.
Ripening the cervix before delivery.
Name a key prostaglandin in labour.
Prostaglandin E2
What types of pessaries can be used to induce labour?
Pessaries containing prostaglandin E2 (dinoprostone).
What are Braxton-Hicks contractions?
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.
When are Braxton-Hicks contractions usually felt?
Second and third trimester
How can Braxton-Hicks contractions be reduced?
Staying hydrated and relaxing
What is cervical effacement?
When the cervix gets thinner from front to back (during first stage of labour)
What is the “show”?
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.
What are the 3 phases of the first stage of labour?
- Latent phase
- Active phase
- Transition phase
What is the latent phase of the first stage of labour?
From 0 to 3cm dilation.
How quickly does the latent phase of first stage of labour progress?
~0.5cm per hour
Are contractions during latent phase of first stage of labour regular or irregular?
Irregular
What is the active phase of the first stage of labour?
From 3cm to 7cm dilation.
How quickly does the active phase of first stage of labour progress?
1cm per hour
Are contractions during active phase of first stage of labour regular or irregular?
Regular
What is the transition phase of the first stage of labour?
From 7cm to 10cm dilation.
How quickly does the transition phase of first stage of labour progress?
1cm per hour.
Are contractions during transition phase of first stage of labour regular or irregular?
Strong and regular
What does the success of the second stage of labour depend on?
- Power (strength of uterine contractions)
- Passenger (qualities of foetus)
- Passage (pelvis)
What are the 4 important qualities of the foetus during the second stage of labour?
- Size (esp. head)
- Attitude (posture)
- Lie (position in relation to mother’s body)
- Presentation (part closest to cervix)
What does longitudinal lie mean?
Foetus is straight up and down
What does transverse lie mean?
Foetus is straight side to side
What does oblique lie mean?
Foetus is at an angle
What does cephalic presentation mean?
Foetus presents head first
What does shoulder presentation mean?
Foetus presents shoulder first
What does breech presentation mean?
Legs are first
What are the three types of breech presentation?
- Complete breech
- Frank breech
- Footling breech
What is complete breech?
Hips and knees flexed (like doing a cannonball jump into a pool)
What is frank breech?
Hips flexes and knees extended, bottom first
What is footling breech?
Foot hanging through the cervix
What are the 7 cardinal movements of labour?
- Engagement
- Descent
- Flexion
- Internal rotation
- Extension
- Restitution and external rotation
- Expulsion
What landmark do obstetricians describe the positions of the baby’s head during the descent phase?
Ischial spines
What does -5 indicate when measuring descent?
Baby is high up at around the pelvic inlet
What does 0 indicate when measuring descent?
Head is at ischial spines (i.e. engaged)
What does +5 indicate when measuring descent
Head has descended further out beyond ischial spines
What does physiological management of the third stage of labour mean?
Placenta is delivered by maternal effort without medications or cord traction.
What does active management of the third stage of labour mean?
Where the midwife or doctor assist in delivery of the placenta.
When is active management of the third stage of labour indicated?
Haemorrhage or more than a 60-minute delay in the delivery of the placenta.
What side effects may active management of the third stage of labour be associated with?
Nausea and vomiting
How is the third stage of labour actively managed?
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.
