normal and abnormal labour delivery Flashcards
1st stage of Labour
cervix is opening and baby is moving down the birth canal
true contractions latent is under 4 active 4-10
cervix effaces and dilates up to 18 hours ( divide by 6 each time for timings per stage of labour )
2nd stage of Labour and 3rd
baby is being born - descent in birth canna up to 3 hours
placenta is delivered - active and physiological up to 30 minutes
what things may Indicate a higher risk brith
- Multiple chronic disease of the mother such as cardiac disease and hypertensive disorders
- Asthma requiring increased treatment , CF
- Haemoglobinopathies , hx of thromemboci disorders – thrombocytopeis, bleeding disorders
- Hyperthyroidism and diabetes ( can cause a bigger baby)
- Hepatitis B/c , deranged LFTs , HIV< toxoplasmosis, chicken pox, rubella, gential herpes and TB
- Lupus and scleroderma
- Abnormal renal function
- Epilepsy, MG , previous CVE
- Psychiatric disorder requiring current inpatient care
abnormal fetal hr
below 100 or above 180
when waters break too early what is it called
PROM- pre-labour rupture of membranes PROM
meconium in the amniotic fluid at membranes rupture indicate what
why does this happen
and what can happen as a consequence
baby had first bowel opening too early
Babies who are stressed by low oxygen levels or infections also may pass meconium before birth. When meconium gets in the amniotic fluid, there’s a chance a baby will breathe (aspirate) it into the lungs before, during, or after birth.
if ph under 7.21 emergency delivery is advised
1st stage of labour normal duration if nulli and multi
8-18 Hours
5-12 hours
2nd stage of labour duration nulli and multi
3 hours
2hours
1cm per hour in active
stage 1 and 2 labour poor progress limited progress due to
- Power – efficiency of uterine contractions - No progress 2 hours after = oxytocin infusion
No progress 4-6 hours will do c section - Passage – route through the uterus, cervix or bony pelvis
- Passenger – foetus size , presentation and position
Hypertonic uterine inertia
-colicky uterus – incoordination of parts of the uterus
Hyperactive lower uterine segment so the dominance of the fundus is lost
Irregular and more painful
Antispasmodics may help
problems with obstructed labour
for the foetus , hpoxi ishcemic encephalopathy , cerebral palsy, neonatal sepsis
for the mother uterine rupture ,viscid-vaginal fistular and PPH
more common in multiparous women is malpresentation, brown presentation need to be delivery via c section. breech you can try to turn whoever at point of labour will be c section as well as transverse lie due to risk of
cord prolapse
fetal macrosomia is a Fetus over what weight
4kg
bishop score
success of induction is related to condition of cervix at start of induction - likelihood os success taking into consideration, position , conssitaancy , effacement , dilation and station
ways to induce labour
membrane sweep should release prostaglandins
ARM 0 artificial rupture of membranes
vagnal pessary PGE2 - dinoprostone - cerivcla ripening
oxytocin - contraction - cervical dilation should increase by more than 2cm per 4 hours
