Normal Labour Flashcards
Keeps uterus settled
Prevents formation of gap junctions
Hinders contractibility of mycoytes
Progesterone
Makes the uterus contract
Promotes prostaglandin production
Oestrogen
oxytocin also promotes prostaglandin production
How do you know when you’re in true labour?
Contractions are evenly spaced out
What is important about the region of the tubal ostia?
This is the pacemaker for the contractions
How many contractions do you usually get?
3-4 every ten mins
-usually last 10-15 seconds
Normal baby head position
Occipito-anterior
-emerges transvers
Which shoulder comes out first?
The anterior one
What is crowning?
When the baby’s head is visible at the opening of the vagina
This scale is the most commonly used method to assess the readiness of the cervix for labour
Bishops score
What is lochia?
The vaginal discharge you get following delivers
1st = lochia rubra (red)
2nd = lochia serosa (brown)
3rd = lochia alba (yellow)
What initiates lactation?
Placental expulsion
1st degree perineal tear?
Tear within vaginal mucosa only
2nd degree perineal tear?
Extends into subcutaneous tissue
3rd degree perineal tear?
Laceration extends into the external anal sphincter
4th degree perineal tear?
Laceration extends through external anal sphincter into rectal mucosa
Risks associated with obstetric choelstasis?
Increased risk of premature birth
Predominant estrogen during reproductive years
Estradiol (most potent oestrogen)
Predominant estrogen during pregnancy?
Estriol (most abundant but weakest oestrogen)
Predominant estrogen during menopause?
Estrone
Fetal cortisol levels increase around labour, what does this cause?
Causes increase in maternal estriol
What happens when oxytocin receptors become activated?
Results in increased phospholipase C activity and more calcium enters the cells cytoplasm
This results in increased uterine contractility
When would you consider labour to be prolonger?
In nulliparous women:
prolonged if longer than 3 hours (with analgesia)
Or longer than 2 hours (without analgesia)
In multiparous women:
prolonged if longer than 2 hours (with analgesia)
or longer than 1 hour (without analgesia)
How long does the third stage of labour usually take?
10 minutes on average
If the 3rd stage of labour takes longer than an hour, what should you do?
Prepare for removal under GA
Why is active management for the 3rd stage preferred?
Lowers the risk of PPH
How does the cervix become softer?
Increases in hyaluronic acid gives increase in molecules among collagen fibres
The decrease in bridging among collagen fibres gives decrease in firmness of the cervix
How do you describe a real contraction?
The feeling is like a wave
The pain starts low, rises until it peaks and finally ebbs away
If you touch the mother’s abdomen it will feel hard during a contraction
How can you make braxton-hicks contractions resolve?
Often resolve with change of position (unlike true contractions)
How long is a contraction?
Initially 10-15 seconds
Max 45 seconds, slowly builds up
In this part of labour, the mum may feel a burning and stinging feeling?
What position may be required in this part of labour and why?
Crowning
Episiotomy may be required to prevent trauma to anal sphincters
3 classic signs that indicate placental separation?
- Uterus hardens and contracts
- Umbilical cord lengthens permanently
- Gush of blood (variable in amount)
How long does it take for tissues to return to normal non-pregnant state?
6 weeks
What initiates lactation?
Placental expulsion
