normal delivery stages predictions stages and management

Question 1

what are 3p’s of normal labour

Answer 1

factors that determine the mechanism of labour

• Power
  
  • maternal contractions
• Passenger
  
  • size, number, position presentation & lie
• Passageway
  
  • _​_soft tissues, cervix, vagina, perineum

Question 2

what are the 3 predictors of labour

Answer 2

1. irregular contractions
2. bloody show
3. rupture of membrane

Question 3

what is the most common presentation in labour

Answer 3

left occiput anterior

Question 4

list the cardinal movements of the fetues

(Even, Dead, Fetuses, Insert, Every,English,Egg)

Answer 4

• Engagement: head inters true pelvis
• Descent: head descends further d/2 contractions
• Flexion: encounters resistence => chin touches chest
• Internal rotation: head turns anterior to pubic symph
• Extension: further descent => extension under pubic arch
• External rotation: head turns 45^o =>shoulders in pelvis
• Expulstion: right shoulder under pubis =>left=> body follows

Question 5

List the 3 stages of labour

Answer 5

First stage: onset of true labour in this stage occurs:

Second stage: stage of feotal delivery

Third stage: stage of placental delivery

Question 6

what is the 4th stage

Answer 6

puerperium where the mother is monitored

Question 7

how long does the first stage take

Answer 7

primiparous: 11-12 hrs
multiparous: 6-8 hrs

Question 8

what occurs in the first stage of labour

Answer 8

1. ROM
2. reg contractions
3. complete cervical effacement

• Latent: 0-4cm.
• Active: 4-10cm
• full dilation = 10 cm

Question 9

what 2 things are required for the onset oftrue labour

Answer 9

1) ROM 2)regular contractions

Question 10

character of regular contractions

Answer 10

Latent: 30s duration. 5-10 min interval

Active: 60s duration. 1-2 min interval

Question 11

what must be monitored during the first stage of labour

Answer 11

• Contractions
• Foetal HR every 1-2hr => every 5-10mins
• Cervical dilation: palpation
• Mother: BP, Pulse,Temp, every 2-4hrs

Question 12

how long should the second stage of labour last

Answer 12

primiparous: 1-2hours
multi: under 1 hr

Question 13

what happens in the 2nd stage of labour

Answer 13

• once cervix is fully dilated (10cm) cardinal movements occur
• Engagement, flexion and internal rotation occur passivley
• once resistance is reached at flexion the contractions allows the rest of the cardinal movements to occur
• expulsion of the baby and delivery

Question 14

what is monitored during the second stage of labour

Answer 14

fetal HR every 10mins

Question 15

how long should the third stage of labour occur

Answer 15

5-15 mins

no longer than 30 mins

Question 16

when should traction be applied to the expel the placenta

Answer 16

only after the ‘signs of seperation have occured’

Question 17

what are the signs of seperation

Answer 17

1. fresh show of blood
2. umbilical cord doesn’t recede
3. uterine body becomes firm and globular
4. cord lengthening outside the vagina

Question 18

what is monitored after the delivery of the placenta

Answer 18

vagina, cervix and perineum

Question 19

why is the mother kept in the delivery room for 1-2 hours after birth

Answer 19

this is when Post Partum Hemorrhage is most likely to occur d/2 relaxation of the uterus

allows I.D of

• retained placenta
• missed laceration