Normal labour

Question 1

Definition

Answer 1

Regular painful contractions associated with progressive effacement and dilatation of the cervix, accompanied with descent of the presenting part
Between 38 and 42 weeks

Question 2

Stages

Answer 2

First stage: latent and active
Second stage
Third stage

Question 3

First stage

Answer 3

Av 8-18 hours for primips
Latent phase: Effacement/dilatation of cervix 3-4cm. Contractions but not painful
Active phase: Regular painful contractions culminating in full dilatation for cervix (av 0.5-1cm/hr in primips; 1-2cm/hr in multips)

Question 4

Second stage

Answer 4

Av. 1-3 hours for primips; 1 hour for multips
From full dilatation of cervix to birth of baby
Passive/active phases

Question 5

Third stage

Answer 5

Usually <30mins
From delivery of baby to delivery of placenta
Active management recommended

Question 6

Physiology of birth - 3 factors

Answer 6

Powers
Passage
Passenger

Question 7

Powers

Answer 7

Primary forces: Uterine contraction => complete effacement and dilatation of cervix
Secondary forces: Abdominal muscles to push during the 2nd stage
Contractions: Frequency, duration, intensity/strength

Question 8

Passage

Answer 8

True pelvis
Bony canal that fetus needs to pass through
Brim/inlet, cavity/mid pelvis, outlet
Gynaecoid
Android
Arthropoid (lengthened AP diameter, shortened tranverse diameter)
Platypelloid (shortened AP diameter, lengthened transverse)

Question 9

Passenger

Answer 9

Lie
Presentation
Engagement
Position
Attitude
Descent

Question 10

Mechanism of normal labour

Answer 10

Engagement
Descent
Flexion of neck
Internal rotation so nose to mum's spine
Extension of neck out
Restitution
External rotation
Delivery shoulders/body

Question 11

Monitoring in labour

Answer 11

Maternal obs
CTG
Abdominal/vaginal exam