Labour And Delivery Flashcards
What happens to the female pelvis during Labour? 4 (uterus, cervix, mucus plug, membrane)
- Regular, patterned uterine fundal contraction
- Progressive effacement and dilation of Cervix
- Loss of the mucus plug
- Rupture of membranes
What is the sign of mucus plug?
Bloody show
What is the sign for rupture of membranes?
Water breaking
What happens during the first stage of labour? 3
- Progressive cervical effacement and dilation
- Descent of fetus into the maternal pelvis
- Regular contractions
How long does the first stage of labour last?
12-24 hours
What is the normal progression time for the first stage of labour for the cervix dilation?
1cm/hr
What happens during the second stage of labour? 2
- Cervix is fully dilated
- Birth of the baby (pushing)
How long does the second stage of labour last? 2
Variable
1. Average 50 minutes - primagravida
2. 20 minutes- multifarious
What happens during the third stage of labour?
Birth to expulsion of placenta
How long is the third stage of labour?
About 10 minutes
What hormone is released in third stage?
Oxytocin
What is critical for labour?
Fetal position
What is the most common position for fetal position?
Cephalic position
What is the percentage of fetus’s that are in breech position?
4%
What is dystocia?
Difficult birth
What is Dystocia often referred to?
Dysfunctional labour
What happens during dysfunctional labour? 2
- Failure to progress- cervix not changing with contractions
- Administration of oxytocin through an IV
What are some signs of dystocia? 4
- Dysfunctional labour
- Disproportion of the fetal head to the maternal pelvis
- Mass obstructing the way
- Abnormal presentation or position - shoulder, face
What are some symptoms of Dystocia? 3
- Placenta previa
- Abruption
- PROM
When is induction of labour performed? 8
- Mild aburption
- IUGR
- Post dates
- Amnionitis
- PROM
- Maternal disease
- Fetal death
- Hx of quick delivery but great distance from hospital
What is meconium?
Black tarry substance in the neonates first bowel movement
What is meconium aspiration?
When the baby has the first bowel movement in utero or in distress
What is a risk of meconium aspiration?
If the fetus inhales meconium before birth
When is a C- section done? 7
- Footling or incomplete breech
- Prolonged membrane rupture and no uterine contractions/ labour has begun
- Fetal distress
- Dysfunctional labour (not progressing)
- > 4kg weight
- Small maternal pelvis
- Social
What are some diagnostic tests done in LND? 3
- L/S ratios
- Non stress test
- Fetal scalp blood gases
Are sonographers invited into LND?
No
What do we call a non stress test with contractions?
Stress test
