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Normal Labour Flashcards

1
Q

What occurs in labour?

A

The foetus, membranes, umbilical cord and placenta are expelled from the uterus

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2
Q

What is a birth plan?

A

A record of what the woman would like to happen during labour and after birth

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3
Q

Which hormones play a role in the onset of labour?

A

Oestrogen

Oxytocin

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4
Q

What is the role of oestrogen in labour?

A

Causes uterus contraction through prostaglandin production

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5
Q

What occurs in Ferguson’s reflex?

A

The head pushing on the cervix sends messages to the pituitary to release oxytocin causing increased contraction

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6
Q

When is the rupture of membranes useful?

A

Towards term - initiates labour

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7
Q

Give some cervical changes that occur during labour

A

Decrease in collagen fibre alignment/strength

Decreased firmness

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8
Q

What 5 criteria are assessed in Bishop’s score?

A 
Position
Consistency
Effacement
Dilatation
Station in pelvis
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9
Q

What is the purpose of Bishop’s score?

A

To determine if it is safe to induce labour

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10
Q

What are the two phases of the first stage of labour?

A

Latent and active

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11
Q

What occurs during the latent phase?

A

Mild irregular uterine contractions with cervix shortening and softening

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12
Q

What occurs in the active phase?

A

Contractions getting stronger

Slow descent of presenting part

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13
Q

What indicates the start of the second stage of labour?

A

Complete dilatation of the cervix

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14
Q

When is the second stage considered prolonged?

A

Nulliparous - exceeding 3 hours with regional analgesia or 2 hours without
Multiparous - exceeding 2 hours with regional analgesia or 1 hour without

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15
Q

What occurs in the third stage of labour?

A

Delivery of baby to expulsion of placenta/foetal membranes

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16
Q

What is the average duration for the third stage of labour?

A

10 minutes

17
Q

What are Braxton-Hicks contractions?

A

Tightening of the uterine muscles that can be confused for labour

18
Q

Which hormone controls true labour contractions?

A

Oxytocin

19
Q

In true labour contractions, the length of time between contractions increases and duration of contractions decreases. True/false?

A

False - length of time between contraction decreases and duration increases

20
Q

What are the three key factors in labour? (Three P’s)

A

Power
Passage
Passenger

21
Q

What is the normal timing for contractions?

A

Up to 3-4 in 10 mins

22
Q

What are the three main types of female pelvis?

A

Gynaecoid
Anthropoid
Android

23
Q

What is the normal foetal position during labour?

A

Longitudinal lie with cephalic presentation and occipito-anterior position

24
Q

What can be palpated to determine foetal position on vaginal examination?

A

Fontanelles

25
Q

Give some analgesia options that may be considered during labour

A 
Paracetamol/co-codamol
TENS
Entonox
Diamorphine
Epidural
Remifentanyl
26
Q

What are the 7 cardinal movements of labour?

A 
Engagement
Descent
Flexion
Internal rotation
Crowning & extension
Restituition & external rotation
Expulsion
27
Q

What occurs in engagement?

A

The widest diameter of the presenting part passes below the plane of the pelvic inlet

28
Q

How can engagement be felt on palpation?

A

By palpating the foetal head in the abdomen - 3/5ths should have entered the pelvis

29
Q

How often should vaginal examinations be carried out in normal labour?

A

4 hourly

30
Q

What occurs in crowning?

A

There is appearance of a large segment of the foetal head at the introitus

31
Q

What is the purpose of delayed cord clamping?

A

To increase the red blood cells an infant receives at birth by 50%

32
Q

What is the current recommendation for skin to skin after birth?

A

Uninterrupted SSC for 1 hour after birth

33
Q

What three signs indicate completion of the third stage?

A

Uterus contraction and hardening
Umbilical cord lengthens permanently
Gush of blood

34
Q

What can be done to manage the third stage of labour?

A

Syntometerine (prophylaxis)

Oxytocin

35
Q

What is a normal blood loss seen in labour?

A

Less than 500ml

36
Q

How is haemostasis achieved in pregnancy?

A

Thrombosis of torn blood vessels

Contraction of uterine muscle to strangulate blood vessels

37
Q

What is puerperium and how long does it last?

A

The return of tissues to a non-pregnant state - lasts 6 weeks

38
Q

Give some uterine changes that occur in puerperium

A

Involution
Fundal height falls
Endometrium regenerates

Reproduction (33 decks)

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