normal labour

Question 1

what is normal labour

Answer 1

painful regular uterine contractions with cervical effacement, dilation and descent of the presenting part

Question 2

what is stage 1 labour split into

Answer 2

latent and established phase

Question 3

what happens in the latent phase stage 1

Answer 3

before 3-4cm dilated.

Question 4

what happens in active phase stage 1

Answer 4

> 4cm dilated up to 10cm

Question 5

length of stage 1 in primip

Answer 5

8-18h

Question 6

length of stage 1 in multip

Answer 6

5-12h

Question 7

what should be monitored in stage 1

Answer 7

temperature and bp 4hourly, pulse hourly, observe contractions every 30 mins. listen to FHR every 15 mins for 1 min after contraction

Question 8

rate of dilations

Answer 8

after 4cm - 0.5cm/hr

Question 9

when does the second stage begin

Answer 9

when the cervix is dilated to 10cm - through to delivery of the fetus

Question 10

what are the stages of the 2nd stage

Answer 10

passive and active

Question 11

what happens in passive phase of 2nd stage

Answer 11

cervix fully dilated but no desire to push

Question 12

what happens in the active phase of 2nd stage

Answer 12

full dilatation and expulsive contractions. baby can be seen

Question 13

what should be monitored in stage 2

Answer 13

pulse and bp hourly, temp 4 hourly, contractions every half hour. listen to FHR every 5 mins for 1 min after contraction

Question 14

how long does stage 2 last in primp and multip

Answer 14

3h - primip, 2h- multip

Question 15

what is the 3rd stage labour

Answer 15

delivery of the placenta

Question 16

what size does uterus contract to after birth

Question 17

what happens in stage 3

Answer 17

uterus contracts to

Question 18

what can be used as the anterior shoulder is delivered

Answer 18

ergometrine + oxytocin (syntometrine)

Question 19

what does using syntometrine do to third stage

Answer 19

decreases the time to 5 min and decr incidence PPH

Question 20

when is syntometrine contraindicated

Answer 20

pre eclampsia, hypertension, liver/renal impairment/ heart disease, hypercholesterolaemia. as can precipitate myocardial infarction

Question 21

if BP hasn’t been measured and want to use a drug during labour what can you use

Answer 21

oxytocin

Question 22

what hormones trigger onset of labour

Answer 22

prostaglandins and oxytocin- uterine contractions and cervical softening

Question 23

what is a show

Answer 23

plug of cervical mucus and some blood as membranes strip from the os

Question 24

what is rupturing of membranes

Answer 24

rupture of amniotic sac

Question 25

why is vaginal exam performed

Answer 25

fetal engagement, cervical effacement, dilatation

Question 26

what part of skull should be felt anteriorly

Answer 26

posterior fontanelle

Question 27

what can be used to measure progress of labour in first stage

Answer 27

Bishops score

Question 28

what is the bishops score based on

Answer 28

cervical length, dilatation, consistency, position of cervix, station of presenting part

Question 29

when is the active phase in score of Bishops score

Answer 29

> 11

Question 30

which stage is hypoxia more common

Answer 30

2nd stage - fetal blood reduces and anaerobic resp with each contraction

Question 31

active management stage 3 to reduce risk PPH

Answer 31

IM oxytocin as babies shoulder is delivered, cord traction with uterine stabilisation, early cord clamping

Question 32

what should be done if there is retained placenta

Answer 32

manual removal