Labour and Management Flashcards
what defines labour?
the regular and increasing uterine contractions with cevical dilation enough for a viable foetus of greater than 22ws, and the placenta and membranes to be delivered
what is stage one labour?
Latent phase - where the cervix becomes effaced - change from 3cm to 0.5cm in depth - there is undifferentation of the internal and external os
Active Phase - cervical dilation from 3-10cm
what is the time frame for normal stage one labour?
latent phase- 6-8hrs in nullipara, 4-6hrs in multipara
active phase - 1cm/hr
what is stage two labour?
time from full cervical dilation to the delivery of the foetus
what is the classification for full cervical dilation?
depends on foetal size and gestation - takes less time to fully dilate for a foetus at 22w compared to 38w
it is when the foetal head is able to pass through the cervix
what is the time frame of stage two labour?
1 hr in nullipara
30mn in multipara
what is stage three labour?
the time between delivery of the foetus and delivery of the placenta
how long does stage three labour? how is this assisted?
15 mins with active management
IM syntronetine given when the anterior shoulder is delivered
Left hand placed on the anterior abdominal wall - with gentle cord action
check for tears or uterine inversion
what are the three causes for slow labour?
Passage -pelvic brim is too small
Passenger - foetus is too large
Power - inadequate uterine contraction
where are the timings of labour recorded?
on a paratograph - lines for time scales to become alert or action to be taken if the time is not progressing
how is the slow active phase managed?
rupture of membranes, justifiable use of oxytocin
how is slow stage two labour managed?
using forceps or a ventouse (vacuum cup)
what is the dosage system for oxytocin for labour induction?
2-4 mu/minute
increase by 2-4 mu every 30mins
stop after 6-8 hrs as unlikely to have an effect here
low and gradual dosing to avoid foetal distress and hyper stimulation
what are the complications of slow labour?
uterine rupture - can cause foetus to die if not delivered within 10 mins
vaginalvesico fistula
shoulder dystocia
what is moulding?
overlapping of the bones of the skull to allow passage through the pelvic brim
extent depends on mothers size
