Normal Delivery And Labour

Question 1

2 phases of first stage of labour?

Answer 1

Latent: slow progress to 3cm (variable duration)
Active: faster rate of dilation starts at 2-4 dilatation.

Question 2

What is spurious labour?

Answer 2

No cervical effacement/dilatation

Question 3

What is the ‘membranes’?

Answer 3

Chorion
Amnion
Fused

Question 4

What is in the membranes?

Answer 4

Fetus, placenta, amniotic fluid

Question 5

Why ARM? 2 reasons

Answer 5

Increased prostaglandins (increase induction)
Idea of fetal well being: volume and colour-myconeum)

Question 6

Labour needs 3 things

Answer 6

Powers: uterine contractions
Passenger: size, lie, presentation, attitude, position
Passage: effacement

Question 7

Attitude of baby?

Answer 7

Degree of extension/flexion of fetal neck

Want them to flexed

Question 8

Position of baby?

Answer 8

Relationship of nominated part of presenting part to location on maternal pelvis

Question 9

Maternal well being during labour?

Answer 9

Infection: chorioamnionitis
Preeclampsia
Intrapartum haemorrhage
Emotional: pain

Question 10

Pain relief non-pharma

Answer 10

Massage, relaxation, breathing, position, hot, cold packs

Question 11

Pharma relief pain in labour?

Answer 11

Inhalation: NO
Systemic: opioids
Neuraxial: epidural/spinal, combined spinal/epidural
Local: pudendal nerve block, perineal infiltration

Question 12

Blood flow placenta during contraction?

Answer 12

Reduced blood flow by 40% every contraction

Question 13

How long is first stage of labour? S1 Nullipara/Multipara?

Answer 13

Nullipara: 6-18 Hrs.
Multi: 2-10hrs.

Question 14

Assess progress of labour

Answer 14

How many contractions in 10 minutes?

Question 15

What is a partogram?

Answer 15

Graph that showed cervical dilatation progress

Question 16

Second stage of labour Head changes in pelvis?

Answer 16

Shape - Moulding
Size - flexion
Position - rotation

Question 17

Caput?

Answer 17

When sutures come together/approximate each other other

Question 18

Moulding is?

Answer 18

when skull plates overlap

Question 19

Suboccipital-bregmatic diameter is?

Answer 19

9.5cm

Question 20

Brow presentation?

Answer 20

13.5cm

Undeliverable

Question 21

Faced presentation?

Answer 21

Face first: 9.5cm

must be Mental anterior

Question 22

Occipitofrontal diameter

Answer 22

11cm

Varies with flexion of head

Question 23

Rotation is?

Answer 23

From OT to OA to help get through mid pelvis

Question 24

What is bispinous in midpelvis?

Answer 24

Smallest diameter in pelvis - ischial spines

Question 25

After head is out, then what?

Answer 25

Want to encourage them to have occiput transverse, then deliver anterior shoulder, then posterior shoulder, then rest of Bodyy

Question 26

Third stage of labour Is?

Answer 26

Separation and expulsion of placenta within 5-10 minutes

Question 27

Signs of separation of placenta?

Answer 27

Fresh show of blood from vagina
Lengthen gin fo umbilical cord
Uterus becomes firm

Gentle traction on cord

Question 28

What is active management of Third stage of labour? Meds?

Answer 28

Oxytocic admin
Syntocinon
Ergometrine(profound smooth muscle contraction! Vomiting)

Question 29

When need to go to theatre for tearing perineum?

Answer 29

3rd and 4th degree tear

Question 30

Why episiotomy?

Answer 30

So if it tears, it extends away from anal sphincter

Question 31

Summary of this lecture

Answer 31

Know the 3s of lecture