maternal care

Question 1

How many women in the UK die of maternal death?

Answer 1

1 in 5800

Question 2

What are the 3 delays leading to maternal death

Answer 2

1. recognizing the problem
2. seeking help
3. efficiency of help

Question 3

Criteria for a normal birth

Answer 3

1. Labour starts spontaneously
2. birth between 37/42 weeks of pregnancy
3. no medical induction of labor
4. baby and mother are well afterwards

Question 4

Describe 2 main events of passive labor (stage 1)

Answer 4

painful irregular contractions

effacement and dilatation of cervix (up to 4 cm)

Question 5

Describe 2 main events of active labor (following passive labor)

Answer 5

Regular contractions, dilatation of about .5cm per hour to reach 10cm.

Question 6

How is monitor labour

Answer 6

Chart with contraction, dilatation, vital, urine output. Position and vitals of baby.

Question 7

Describe main signs of the transition into second stage of birth

Answer 7

uncontrollable urge to push, sweating, mood change, feels head in vagina.

Question 8

Describe the second stage (active and passive) of birth

Answer 8

Passive 2: full dilatation, no expulsive contractions. Takes about 1h, but can be more.
Active 2: baby visible, expulsive contractions, full dilatation, birth

Question 9

Describe 3rd stage of labor

Answer 9

placenta separates from the uterine wall and is expelled along with the membranes.breastfeeding can help trigger this stage

Question 10

define active management in third stage of labor

Answer 10

1. give uterotonic drugs to cause placental separation
2. defer clambing and cutting of cord
3. control cord traction after signs of separation of the placenta.

Question 11

Define puerperium

Answer 11

the time from the end of the third stage through the first 6 weeks after delivery. Time at which increase risks of depression, postpartum haemorrage.

Question 12

Define parturition

Answer 12

Giving birth. The process involves softening and effacement of the cervix and developement of contractions.

Question 13

Explain what causes the cervix to ‘ripen’ before birth and how this occurs

Answer 13

Hormonal changes causes an inflammatory process in the tissue involing COX - 2 and iNOS and the production of protaglandins.

Question 14

What is the myometrium?

Answer 14

Smooth muscle causing uterine contractions

Question 15

What causes the contractions to start in the myometrium?

Answer 15

Increase in COX - 2, so prostaglandins as well as oxytocin receptors. Also increase in gap junctions (connexins)

Question 16

What possible mechanisms lead to birth in humans?

Answer 16

1. Placenta produces ACTH and oxytocin -> increased prostaglandin -> increased inflammation
2. Increase in estrogen dominance, loss in progesterone function
3. Stretch mediated response?
4. Lung growth and pulmunary surfactant produced promoting inflammation?

Question 17

Prolactin levels are high and mamary glands fully differentiated at 16 weeks but no milk is produced. Why is that?

Answer 17

Because estrogen and projesterone inhibit milk production -> their withdrawal is essential for milk production.