Labour & delivery

Question 1

When does labour usually occur?

Answer 1

between 37- and 42-weeks gestation.

Question 2

What is the first stage of labour?

Answer 2

The first stage is from the onset of labour (true contractions) until 10cm cervical dilatation.

Question 3

What is the 2nd stage of labour?

Answer 3

The second stage is from 10cm cervical dilatation to delivery of the baby.

Question 4

What is the third stage of labour?

Answer 4

The third stage is from delivery of the baby to delivery of the placenta.

Question 5

What is the role of prostaglandins in labour

Answer 5

They stimulate contraction of the uterine muscles. They also have a role in the ripening of the cervix before delivery.
One key prostaglandin to know is prostaglandin E2. Pessaries containing prostaglandin E2 (dinoprostone) can be used to induce labour.

Question 6

What are braxton Hicks contractions?

Answer 6

Braxton-Hicks’s contractions are occasional irregular contractions of the uterus. They are usually felt during the second and third trimester.

They do not indicate the onset of labour and do not progress or become regular.

Question 7

What are the cardinal movements of labour?

Answer 7

	Engagement
	Descent
	Flexion
	Internal Rotation
	Extension
	Restitution and external rotation
	Expulsion

Question 8

In the third stage of labour, what are risks and the role of active management?

Answer 8

Risk of haemorrhage if more than a 60-minute delay in delivery of the placenta, Active management can be associated with nausea and vomiting.

Active management involves giving a dose of intramuscular oxytocin to help the uterus contract and expel the placenta.

Question 9

Describe breech presentation

Answer 9

Breech presentation – the legs are first. This can be:

Complete breech – with hips and knees flexed (like doing a cannonball jump into a pool)

Frank breech – with hips flexed and knees extended, bottom first

Footling breech – with a foot hanging through the cervix

Question 10

What is cephalic and shoulder presentation?

Answer 10

o Cephalic presentation – the head is first.

o Shoulder presentation – the shoulder is first.