Normal birth and puerperium

Question 1

Describe early labour

Answer 1

Painful contractions, cervical effacement + dilation up to 4cm

Question 2

What is the normal rate of dilatation in the first stage of labour

Answer 2

0.5 cm/hr

Question 3

Describe the different modes of pain relief that are available during labour

Answer 3

Pharmacological: entonoc, opioids
Epidural
Breathing and relaxation, massage + water

Question 4

Describe the second stage of labour

Answer 4

Passive and active parts.

Passive: full dilatation of cervix, no contractions - lasts an hour

Active: baby is visible, expulsive contractions

Question 5

Which of the baby’s shoulders are delivered first in childbirth?

Answer 5

Anterior shoulder then posterior shoulder

Question 6

Describe the third stage of labour

Answer 6

Placenta separates from uterus, descends into lower segment of uterus and then is expelled with its membrane.
Breast feeding can stimulate a contraction, helping to separate the placenta from the womb.

Question 7

Compare active and physiological management of the third stage of labour

Answer 7

Active - routine use of utertonic drugs, deffered clamping and cutting of cord + controlled cort traction after signs of separation of placenta

Physiological - no use of uterotonic drugs, no clamping of cord until pulsation has stopped + delivery of placenta by maternal effort

Question 8

What are the symptoms of postpartum haemorrhage?

Answer 8

Faintness, dizziness, palpitations + tachycardia

Question 9

What are the symptoms of pre-eclampsia

Answer 9

Headaches + visual disturbances, nausea, vomiting

Question 10

What are the symptoms of thromboembolism

Answer 10

Unilateral calf pain, redness or swelling

Shortness of breath/chest pain