Normal Labour Flashcards
Where is oxytocin synthesised in labour?
Decidual and extrembryonic tissue
What does oxytocin do in labour?
Initiates and sustains contractions
A women is 4cm dilated and is experiencing mild contractions. What stage of labour is she in?
Latent first stage
A women in 8cm dilated. What stage of labour is she in?
Active first stage
After how many hours is labour considered prolonged in a nulliparous women?
3 hours with analgesia
2 hours without
After how many hours is labour considered prolonged in a multiparous women?
2 hours with analgesia
1 hour without
In the third stage of labour how long would you wait before preparing from removal of the placenta under GA?
1 hour
Is active or expectant management of the third stage of labour preferred for reducing the risk of PPH?
Active
Describe active management of the third stage of labour?
Oxytocin 10 units Ergometrne 1ml Cold clamping and cutting Controlled cord traction Bladder emptying
What cervical changes accompany true labour contractions?
Softening
Effacement
Dilataion
Where is the pacemaker of contractions?
Tubal ostia
What is a normal number of contractions in active labour?
3 - 4 in 10 minutes
What is the normal position and lie of the fetus at labour?
Longitudinal lie
Cephalic presentation with vertex as presenting part
Occiptio anterior (though head engages in occipito transverse)
How often should vaginal examinations be performed in normal labour?
4 hourly
What is crowning?
Appearance of a large segment od fetal head at the introitus
What 5 things are recorded in the bishops score?
Dilation Effacement Station Cervical consistency Cervix position
What is normal blood loss in labour?
Less than 500ml
What 3 signs indicate that separation of the placenta has occured?
Uterus contracts, hardens and rises
Umbilical cord lengthens
Gush of blood
How long after delivery does expulsion of the placenta normally occur?
5 - 10 minutes (considered normal after 30 mins
How long does it take for the tissues to recover to a non pregnant state after delivery?
6 weeks
What is lochia?
Vaginal discharge after delivery containing blood, mucus and endometrial castings
How long after delivery until the fundal height is at the umbilicus?
2 weeks
How long does it take for the endometrium to regenerate?
End of 1 week
What initiates lactation?
Decrease in oestrogen and progesterone
