Normal Labour Flashcards
Mechanisms involved in onset of labour?
- alteration in oestrogen/progest ratio
- PG are released which act on cervix and sensitize uterus to oxytocin
- release of fetal oxytocin
- pressure of fetal head on cervix
- overstretching of myometrium
What are the 3 Ps?
Power
- uterine/primary
- maternal bearing down / secondary
Passage
- soft tissues of birth canal cervix vagina pelvic contents and floor and perineum
- bony pelvis
Passenger
- fetus
- placenta and membranes
What is prelabour?
Stage may have braxton-hicks contractions
Cervical efacemet and ripening
Lower uterine segement expands as head descends
What is false labour?
Painful contractions
No cervical dilatation or effacment
NB Check fetal well being
First stage of labour?
Period from the onset of labour to full dilatation of cervix.
Object is to achieve full cervical dilatation.
Made up of latent and active phase
Ideal contractions 4in10min
Bearing down efforts should be enocuraged in this stage
What is moulding?
Parietal bones slip under eachother and over the occipital and frontal bones
1+ 2+ 3+
Sign if CPD
What is caput?
Oedema of fetal scalp indicating pressure of cervix on fetal scalp.
What is the second stage of labour?
Period from full dilatation of cervix until fetus is delivered
What is second stage of labour?
Full dilatation of cervix until infant is delivered? Sx of 2nd stage - urge to push -feeling of defaecation Nausea and vomitting Head on perineum
What is the 3rd stage of labour?
From the expulsion of the fetus until placenta and membranes are delivered.
Signs of placental Spearation
Pv bleeding
Lengthening of umbilical cord
Rise in fundal height
Fundus becomes globular and firm
What occurs during a normal labour?
- contraction and retraction of upper uterine segement
- effacement and dilatation of cervix
- descent of presenting part
- maternal bearing down efforts expelling yhe fetus
- expulsion of placenta and membranes
