Normal Delivery And Labour Flashcards
2 phases of first stage of labour?
Latent: slow progress to 3cm (variable duration)
Active: faster rate of dilation starts at 2-4 dilatation.
What is spurious labour?
No cervical effacement/dilatation
What is the ‘membranes’?
Chorion
Amnion
Fused
What is in the membranes?
Fetus, placenta, amniotic fluid
Why ARM? 2 reasons
Increased prostaglandins (increase induction) Idea of fetal well being: volume and colour-myconeum)
Labour needs 3 things
Powers: uterine contractions
Passenger: size, lie, presentation, attitude, position
Passage: effacement
Attitude of baby?
Degree of extension/flexion of fetal neck
Want them to flexed
Position of baby?
Relationship of nominated part of presenting part to location on maternal pelvis
Maternal well being during labour?
Infection: chorioamnionitis
Preeclampsia
Intrapartum haemorrhage
Emotional: pain
Pain relief non-pharma
Massage, relaxation, breathing, position, hot, cold packs
Pharma relief pain in labour?
Inhalation: NO
Systemic: opioids
Neuraxial: epidural/spinal, combined spinal/epidural
Local: pudendal nerve block, perineal infiltration
Blood flow placenta during contraction?
Reduced blood flow by 40% every contraction
How long is first stage of labour? S1 Nullipara/Multipara?
Nullipara: 6-18 Hrs.
Multi: 2-10hrs.
Assess progress of labour
How many contractions in 10 minutes?
What is a partogram?
Graph that showed cervical dilatation progress
Second stage of labour Head changes in pelvis?
Shape - Moulding
Size - flexion
Position - rotation
Caput?
When sutures come together/approximate each other other
Moulding is?
when skull plates overlap
Suboccipital-bregmatic diameter is?
9.5cm
Brow presentation?
13.5cm
Undeliverable
Faced presentation?
Face first: 9.5cm
must be Mental anterior
Occipitofrontal diameter
11cm
Varies with flexion of head
Rotation is?
From OT to OA to help get through mid pelvis
What is bispinous in midpelvis?
Smallest diameter in pelvis - ischial spines
After head is out, then what?
Want to encourage them to have occiput transverse, then deliver anterior shoulder, then posterior shoulder, then rest of Bodyy
Third stage of labour Is?
Separation and expulsion of placenta within 5-10 minutes
Signs of separation of placenta?
Fresh show of blood from vagina
Lengthen gin fo umbilical cord
Uterus becomes firm
Gentle traction on cord
What is active management of Third stage of labour? Meds?
Oxytocic admin
Syntocinon
Ergometrine(profound smooth muscle contraction! Vomiting)
When need to go to theatre for tearing perineum?
3rd and 4th degree tear
Why episiotomy?
So if it tears, it extends away from anal sphincter
Summary of this lecture
Know the 3s of lecture
