Normal Labour

Question 1

Where is oxytocin synthesised in labour?

Answer 1

Decidual and extrembryonic tissue

Question 2

What does oxytocin do in labour?

Answer 2

Initiates and sustains contractions

Question 3

A women is 4cm dilated and is experiencing mild contractions. What stage of labour is she in?

Answer 3

Latent first stage

Question 4

A women in 8cm dilated. What stage of labour is she in?

Answer 4

Active first stage

Question 5

After how many hours is labour considered prolonged in a nulliparous women?

Answer 5

3 hours with analgesia

2 hours without

Question 6

After how many hours is labour considered prolonged in a multiparous women?

Answer 6

2 hours with analgesia

1 hour without

Question 7

In the third stage of labour how long would you wait before preparing from removal of the placenta under GA?

Answer 7

1 hour

Question 8

Is active or expectant management of the third stage of labour preferred for reducing the risk of PPH?

Answer 8

Active

Question 9

Describe active management of the third stage of labour?

Answer 9

Oxytocin 10 units
Ergometrne 1ml
Cold clamping and cutting
Controlled cord traction
Bladder emptying

Question 10

What cervical changes accompany true labour contractions?

Answer 10

Softening
Effacement
Dilataion

Question 11

Where is the pacemaker of contractions?

Answer 11

Tubal ostia

Question 12

What is a normal number of contractions in active labour?

Answer 12

3 - 4 in 10 minutes

Question 13

What is the normal position and lie of the fetus at labour?

Answer 13

Longitudinal lie
Cephalic presentation with vertex as presenting part
Occiptio anterior (though head engages in occipito transverse)

Question 14

How often should vaginal examinations be performed in normal labour?

Answer 14

4 hourly

Question 15

What is crowning?

Answer 15

Appearance of a large segment od fetal head at the introitus

Question 16

What 5 things are recorded in the bishops score?

Answer 16

Dilation
Effacement
Station
Cervical consistency
Cervix position

Question 17

What is normal blood loss in labour?

Answer 17

Less than 500ml

Question 18

What 3 signs indicate that separation of the placenta has occured?

Answer 18

Uterus contracts, hardens and rises
Umbilical cord lengthens
Gush of blood

Question 19

How long after delivery does expulsion of the placenta normally occur?

Answer 19

5 - 10 minutes (considered normal after 30 mins

Question 20

How long does it take for the tissues to recover to a non pregnant state after delivery?

Answer 20

6 weeks

Question 21

What is lochia?

Answer 21

Vaginal discharge after delivery containing blood, mucus and endometrial castings

Question 22

How long after delivery until the fundal height is at the umbilicus?

Answer 22

2 weeks

Question 23

How long does it take for the endometrium to regenerate?

Answer 23

End of 1 week

Question 24

What initiates lactation?

Answer 24

Decrease in oestrogen and progesterone