Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Systems: Reproduction AB > Normal Labour > Flashcards

Normal Labour Flashcards

1
Q

What is labour?

A

Labour is the process in which the foetus, placenta and membranes are expelled via the birth canal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does normal labour usually occur

A

In normal labour occurs spontaneously, at term (37-42 weeks gestation), with the foetus presenting by the vertex and results in a spontaneous vaginal birth (SVD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is labour triggered?

A

By paracrine and autocrine signals generated by maternal, foetal and placental factors which interplay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the key physiological changes which must occur before expulsion of the foetus will occur?

A
  • Cervix softens
  • Myometrial tone changes to allow for coordinated contractions
  • Progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the latent first stage of labour?

A

A period during which there are intermittent, often irregular painful contractions which bring about some cervical effacement and dilatation up to 4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the established first stage of labour?

A

Regular, painful contractions that result in progressive effacement and cervical dilatation from 4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is the first stage of labour complete?

A

When the cervix is fully dilated (10cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How long does the first stage of labour last?

A

Length of established first stage of labour varies between women but for a primagravida this stage lasts on average 8 hours (unlikely to last longer than 18 hours) and for a multigravida this stage lasts on average 5 hours (unlikely to last over 12 hours).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How fast does the first stage of labour progress?

A

0.5-1cm per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the cervix thin and dilate?

A
  • Uterine contractions start at the fundus, the top of the uterus and move down and across.
  • This exerts pressure on the fetal pole which encourages flexion and a well applied presenting part which in turn puts pressure on the cervix to thin and dilate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does stage 2 of labour encompass?

A

From full cervical dilatation to the birth of the baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the passive second stage of labour?

A
  • Finding of full dilatation of the cervix before or in the absence of involuntary expulsive contractions.
  • Plan to allow one hour of passive second stage to allow for further fetal descent.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the active second stage of labour?

A
  • The presenting part is visible.
  • Expulsive contractions with a finding of full dilatation of the cervix.
  • Active maternal effort following confirmation of full dilatation of the cervix in the absence of expulsive contractions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long should the second stage of labour last?

A
  • In a primagravida birth would be expected within two hours of active second stage commencing
  • For a multigravida birth would be expected within one hour of active second stage commencing.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the third stage of labour?

A

Time from the birth of the baby to the expulsion of the placenta and membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does active management of the third stage of labour involve?

A

Package of care

  • Routine use of uterotonic drugs
  • Deferred clamping and cutting of the cord
  • Controlled cord traction after signs of separation of the placenta
17
Q

What does physiological management of the third stage of labour involve?

A

Package of care

  • No routine use of uterotonic drugs
  • No clamping of the cord until pulsation has stopped
  • Delivery of the placenta by maternal effort
18
Q

When is the third stage of labour considered delayed?

A
  • If not completed within 30 minutes of the birth with active management
  • If not completed within 60 minutes of the birth with physiological managemnet
19
Q

How should progress be monitored during labour?

A
  • Blood pressure, pulse, temperature, respirations, oxygen saturation, urine output and urinalysis
  • Abdominal palpation
  • Vaginal examination
  • Monitoring of liquor once spontaneous or artificial rupture of membranes has occurred
  • Auscultation of the foetal heart
  • Palpation of the uterine muscle contractions
  • External signs
20
Q

What is abdominal palpation used to assess?

A

Foetal lie, presentation, attitude, denominator, position and engagement

21
Q

What is vaginal examination used to assess?

A

Used to assess presentation, engagement and station, position, cervical effacement and dilatation and presence/ absence of membranes

22
Q

How is the foetal heart auscultated

A
  • Intermittently with handheld Doppler or Pinards

- Continuosly with CTG

23
Q

When is intermittent monitoring of babies heartbeat carried out?

A
  • Every 15 minutes in the first stage of labour

- Every 5 minutes in the second stage of labour

24
Q

Where should information be recorded during labour?

A

Partogram

25
Q

What uterine muscle contractions should be aimed for?

A

3-4 every 10 mintues lasting approximately 40-60 seconds of moderate to strong strength

26
Q

Give examples of foetal lie.

A
  • Longitudinal lie
  • Oblique lie
  • Transverse lie
27
Q

Give examples of foetal presentation.

A
  • Face presentation
  • Brow presentation
  • Vertex presentation
  • Breech presentation
  • Shoulder presentation
28
Q

Give examples of foetal attitude.

A
  • Occipitofrontal
  • Submentobregmatic
  • Occipitotomental
  • Subccipitobregmatic
29
Q

What is position of foetus determined in relation to?

A

Occipitut (posterior fontanelle)

30
Q

What is the mechanism of labour?

A
  • Descent
  • Flexion
  • Internal rotation of the head
  • Crowning and extension of the head
  • Restitution
  • Internal rotation of the shoulders
  • External rotation of the head
  • Lateral flexion
31
Q

What types of analgesia can be used in labour?

A
  • Breathing, massage, TENS, paracetamol and dihydrocodeine
  • Water
  • Entonox (inhalational nitrous oxide and oxygen)
  • Opioids (morphine, diamorphine, pethidine)
  • Remifentanil patient controlled analgesia
  • Epidural
  • Consider maternal position and mobility as means of reducing pain and facilitating progress in labour

Systems: Reproduction AB (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions