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3a Obs and Gynae > Normal Labour > Flashcards

Normal Labour Flashcards

1
Q

Normal birth is _____ in onset, low-risk at the start of labour and remaining so throughout labour and delivery. Infant born in ____ position between __ and 42 weeks of pregnancy. After, mother and infant in good condition.

A

spontaneous
vertex
37

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2
Q

What happens during latent phase?

A

Contractions (irregular)
Mucoid plug (“show”)
Cervix beginning to efface and dilate
Can last up to 3 days

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3
Q

What happens in the first stage of labout?

A

Stronger uterine contractions
Cervix is continuing to efface and dilate up to 10 cm.

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4
Q

In the first stage of labour, the cervix dilates up to…

A

10cm

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5
Q

What does the second stage of labour involve?

A

From full dilatation to the birth of the foetus (pushing)

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6
Q

Having contractions every - minutes indicates first stage of labour

A

2-3

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7
Q

What does the third stage of labour involve?

A

From the birth of the foetus to the expulsion of the placenta

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8
Q

What happens during a physiological third stage

A

Women wait for placenta delivery (normally 1 hours)
Separation bleed as placenta becomes ready to be delivered

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9
Q

Active third stage

A

Give oxytocin and ergometrine as IM injection into leg or arm to help contract to help deliver placenta in 5-10 mins after baby. Reduces risk of heavy bleeding.

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10
Q

Rate of dilatation of cervix in women who’s never given birth before

A

1/2 cm an hour

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11
Q

What does surge in oxytocin do?

A

At onset of labour will contract the uterus.
Can have membrane sweep to encourage oxytocin

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12
Q

Prostaglandins role in labour

A

Aid cervical ripening

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13
Q

Oestrogen at onset of labour

A

Inhibits progesterone to prepare the smooth muscles for labour

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14
Q

Prolactin

A

Begin process of milk production in the mammary glands

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15
Q

What causes pelvic girdle pain

A

Weight of baby on pelvis. Ligaments are relaxed due to hormones in pregnancy

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16
Q

Antenatal colostrum harvesting

A

34 weeks, massage breast to see if milk can be collected and stored in fridge. Surge in hormones

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17
Q

What is colostrum?

A

First form of breastmilk. Nutrient dense and high in antibodies and antioxidants.
After 2-4 days production changes to breast milk

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18
Q

94% babies will be in ____ position at end of pregnancy

A

Cephalic

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19
Q

3% of babies will be in _____ position

A

breech

20
Q

1% babies will be in _____ position

A

transverse

21
Q

Contractions start in the ____

A

fundus (top of uterus)
Hormones cause retraction and shortening of muscle fibres.
(Like tennis ball at entrance of balloon, sides of balloon getting pulled up until ball can drop out.)

22
Q

What is cervical effacement? (aka ripening)

A

Thinning of cervix

23
Q

How is dilation measured?

A

Done by vaginal examination
Measured in cm

24
Q

What is the most common shape of woman’s pelvis?

A

Gynecoid
Wide sacrum
Straight side walls with blunt ischial spine

25
Q

Foetal skull is made up of _ bones that are not fully formed

A

3

26
Q

Mechanisms of Labour
1) ______

A

Descent
Can occur from 37 weeks.
Encouraged by increased abdo muscle tone

27
Q

Mechanisms of labour
2) ____

A

Flexion

Contraction exerts pressure down foetal spine towards occiput, forcing occiput to meet pelvic floor. Foetal neck fxlees allowing circumference of babies head to reduce.

28
Q

Mechanisms of labour
3)

A

Internal rotation

Each contraction, head pushed to pelvic floor, then rotates head 90 degrees so comes out facing out direction of mothers back.

29
Q

Mechanisms of labour:
4)

A

Extension
Foetal occiput will slip beneath suprapubic arch allowing head to extend.

30
Q

Mechanisms of labour
5)

A

Restitution/external rotation

Foetus may naturally align its head with the shoulders. This is visible.

(if it doesn’t do this, suggests shoulder dystocia)

31
Q

Mechanisms of labour:
6)

A

Delivery of body
Gentle axial traction my be conducted by midwife

32
Q

What does SROM stand for?

A

Spontaneous rupture of membranes

33
Q

What does ARM stand for?

A

Artificial Rupture of Membranes

34
Q

True or false: foetus can swallow the amniotic fluid

A

True
Helps to create urine and meconium. Rich in stem cells.

35
Q

Rarely, foetus can be born within the amniotic sac known as…

A

en caul

36
Q

What is delayed cord clamping?

A

Umbilical cord is not immediately clamped and cut at the point of birth, Wait at least1 minute to transfuse blood to the baby. Could receive up to 214g of blood. Increase in red blood cells, iron and stem cells.

37
Q

How many arteries and veins does the umbilical cord hold?

A

2 arteries and 1 vein

38
Q

True of false: Vein supplies oxygen and 2 arteries bring deoxygenated blood away from baby/

A

True

39
Q

Alcohol and ____ can be passed to foetus via the placenta, along with maternal antibodies to protect against infection.

A

nicotine

40
Q

What are the 2 membranes of the placenta?

A

Amnion which is around the baby
Chorion

41
Q

Pros of pool birth

A

Analgesic aspects
Promotes calmness
Hands off approach
Upright birth

42
Q

Holistic pain management options

A

Water immersion
Aromatherapy
Massage
Hypnobirthing
TENS machine

43
Q

Pain management

A

Entonox (gas and air)
Paracetamol
Codeine
Opioids (diamorphine, pethidine, remifentanyl)
Epidural

44
Q

Pros of entonox

A

Fast acting (20-30 seconds)
Can be used alongside other analgesia

45
Q

Epidural Pros

A

Total pain relief in 90%
Effect will last until baby is born

46
Q

Epidural cons

A

Reduced mobility
Can take an hour to take effect
Will need a urinary catheter
Can slow own labour

3a Obs and Gynae (3 decks)

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