Maternity Patient

Question 1

Full term

Answer 1

37-42 weeks

Question 2

Preterm

Answer 2

24 - <37 weeks

Question 3

First stage labour contraction times

Answer 3

Regular painful contractions every 2-20 mins, 20-60 secs in duration

Question 4

Imminent birth presentation

Answer 4

• Active pushing / grunting
• Rectal pressure – urge to use bowels or bladder
• Anal pouting / bulging perineum
• Strong unstoppable urge to push
• Presenting part (baby’s head) on view – crowning
• Birth parent’s statements can include – “I am going to have the baby” and “I need to push”

Question 5

Assessment questions

Answer 5

• Number of previous pregnancies
• Prior C-sections
• Length of previous labours
• Weeks pregnant
• single or multiple
• Ruptured membranes?
• Contractions and frequency and duration
• Urge to push
• Foetal movement
• Pregnancy complications

Question 6

Signs of placental seperation

Answer 6

• Uterus rises in the abdomen
• Uterus becomes firmer - assess via gentle palpation at the fundus
• Trickle or gush of blood from the vaginal opening
• Lengthening of the cord is observed
• Birthing parent may feel cramping, a contraction or an urge to bear down
• Placenta may be visible at the vaginal opening

Question 7

Modified active Mx of third stage

Answer 7

• Administer Oxytocin 10 units IM immediately after birth
• Wait for cord to stop pulsating and clamp/cut
• Observe for signs of placental seperation
• When noted, apply gently cord traction in a downward motion while guarding the uterus
• When placenta is at vaginal opening, use two hands to support and slowly remove placenta using twisting motion.
• If resistance, do not apply traction; leave it a reassess after 10 mins
• If successful, immediently locate funds and massage to encourage uterine contraction
• Note time of placenta birth.