Normal Labour Flashcards
What happens in the second stage of labour?
Baby is born - complete dilation to birth
This first stage of labour can be divided into 2 parts, what are they?
Latent - less than 4cm
Active - more than 4 cm
How long is the 1st stage of labour in nullip and miltip?
12 hours nullip (1cm per hour)
7 hours mulitp (2 cm per hour)
How long is the second atage of labour in a nullip and multip?
45 - 2h in nullip not be more than 2 h
15-45 mins in multip - should not be more than 1 hr
What happens in the third stage of labour?
Delivery of placenta
How can you aid placental delivery?
Syntometrine (ergometrine+oxytocin)
Gentle cord traction
What shape is the anterior fontanelle?
diamond
What shape is the posterior fontanelle?
Y shaped
What age does the anterior and posterior fontanelle ossify by?
Anterior by 2 years old
Posterior in the first few months
What is the line between the two fontanelle a called?
Saggital suture
What is the station of a baby?
How far down the head is in relation to the ischial spines
If the baby’s head is above the ischial spines is this a positive or negative station?
Negative
What is moulding?
How much overlap there is between the fetal skill bones
What is the caput?
Localised swelling on the baby’s head due to pressure of the cervix and pelvic inlet
In OA position, the ideal position, where would the posterior suture be?
Closest to mothers pubic symphysis
If the anterior fontanelle is in a central position what position is the baby likely to be in?
Brow presentation
May also feel lips and nose
When is a VE contraindicated?
Premature rupture of membranes
Placenta praevia
After the head has been delivered which movement should the midwife wait for before delivering the shoulders?
External rotation of the head
How long should contractions last for?
40-60 seconds
What is the average diameter of pelvic inlet?
Pelvic outlet?
13x11 cm
11x13 cm
What is the smallest diameter of the fetal head?
9.5cm at full flexion
At wha position does the baby’s head enter the pelvis?
R or L occipit transverse
Which forceps would you use to rotate a baby?
Keillands forceps
What is another name for restitution?
External rotation
What is external rotation?
Turning outwards or away from midline
Which forceps have both a pelvic and cephalic curve?
Neville Barnes forceps
What is the maximum number of attempts to deliver a baby with forceps
3 contractions with traction
Do you need to suture a first degree tear?
No it is only the skin that is damaged
Can suture if it won’t stop bleeding
If a tear involves the perineal muscles but not the anal sphincter what degree is it?
Second degree
Describe stage 3 tears (3a-c)
3a - less than 50% EAS
3b - more than 50% of EAS
3c - both EAS and IAS torn
What is a fourth degree tear?
Through to anal epithelium
What are the two most common causes of secondary PPH?
Infection
Retained products of conception
At station 0 the presenting part is level with what part of the pelvis?
Ischial spines
What percentage of women are resus negative?
15%
