Brainscape's Knowledge GenomeTM

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


See full index

Reproduction SOH > Normal labour > Flashcards

Normal labour Flashcards

1
Q

The 3 P’s that are important in labour

A

Power - uterine contractions
Passage - maternal pelvis
Passenger - foetal position

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

Power - uterine contractions

A

Normal contractions have a regular pattern and adequate resting “tone”
Upper segment of uterus contracts
Lower segment of uterus strewtches, dilates and relaxes

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

Passage - maternal pelvis. Name 3 different pelvis shapes

A

Gynaecoid pelvis
Anthropoid pelvis
Android pelvis

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

Passage - maternal pelvis. What is the most suitable female pelvis shape?

A

Gynaecoid pelvis

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

Passenger - foetal position. What is the normal foetal position?

A

Longitudinal lie
Cephalic (vertex) presentation
Occipito-anterior (baby’s head facing the floor)

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

Passenger - foetal position. How can you detect the position of the baby?

A

Feel for fontanelles on baby’s scalp

  • anterior: diamond shape
  • posterior: triangular shape
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

At which stage in pregnancy are birth plans discussed?

A

7 months gestation

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

Onset of labour

A

Change in oestrogen/progesterone ratio

Mechanical stretch of cervix

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

Onset of labour - ferguson’s reflex

A

Baby’s head pushes against cervix. This sends a message to the pituitary gland to release oxytocin.
Oxytocin is released which pushes baby down more.

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

What is the function of progesterone in labour?

A

Keeps the uterus settled

Hinders the contractibility of myocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the function of oestrogen in labour?

A

Makes the uterus contract

Promotes prostaglandin formation

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

What is the function of oxytocin in labour?

A

Initiates and sustains contractions

Promotes prostaglandin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Increased foetal cortisol production stimulates an increase in maternal ?????

A

estriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Onset of labour - cervical changes - which 5 parameters do you assess?

A 
Effacement 
Dilatation
Firmness
Position
Level of presenting part / station
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Onset of labour - cervix gets more firm/soft?

A

Soft

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

Rupture of membranes - definition

A

Amniotic sac bursts and waters break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the function of liquor?

A

Nurtures and protects foetus.

Facilitates movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rupture of membranes - timing

A 
Pre-term
Pre-labour
First stage of labour 
Second stage of labour 
Born in a caul (born inside sac)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

At which “timing” does rupture of membranes most commonly occur?

A

First stage of labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Bishops score?

A

Determines the likelihood of a patient going into labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

High bishops score means….

A

Patient is likely to go into labour themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Low bishops score means…

A

Patient may require induction of labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Contractions that are typically felt in the 3rd trimester. The contractions are irregular and do not increase in frequency and intensity. What are they called?

A

Braxton Hicks Contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Braxton hicks contractions are the same as true labour contractions. True or false?

A

False

  • braxton hicks contractions are false labour contractions
  • give women a false sensation that they are having real contractions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the role of braxton hicks contractions?

A

Tighten uterine muslces to prepare the body for birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

True labour contractions occur due to the release of _____

A

Oxytocin

- as this stimulates the uterus to contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The blood supply to the uterus is not impaired by contractions/ True or false?

A

False

  • it is impaired
  • every time the uterus contracts, the blood supply to the uterus is impaired
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

True labour contractions have an irregular rhythm. true or false?

A

False

- regular rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

True labour contractions become longer/shorter in length as labour progresses?

A

Longer

- max duration is 45 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

True labour contractions become more/less frequent as labour progresses?

A

More

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How many contractions are normal in 10 min period?

A

3-5 contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

More than 5 contractions in 10 mins is called

A

Hyperstimulation

- abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Less than 3 contraction is

A

Not enough

- abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

True labour contractions become stronger/weaker as labour progresses?

A

Stronger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

True labour contractions become more/less/unchanged painful as labour progresses?

A

More

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the significance of the stretch of the cervix by the foetal head?

A

Increases uterus contractility.
This causes further oxytocin release from the posterior pituitary gland. This causes release of prostaglandins, causing further uterus contractions

37
Q

Which substance is required for a successful labour?

A

Oxytocin

38
Q

How many stages of labour are there?

A

3

39
Q

Stage 1 labour - latent phase

A

Up to 3-4cms dilation of cervix
Mild, irregular uterine contractions
Cervix shortens and softens
Duration is variable

40
Q

Stage 1 labour - active phase

A

4cm onwards to full dilation of cervix

Contractions become more rhythmic and stronger

41
Q

What is full dilation of cervix?

A

10cm

42
Q

Stage 2 labour

A

Full dilation of cervix (10cm) -> delivery of baby

Passage through the birth canal (we want this to be as short as possible)

43
Q

Stage 2 labour - passage through the birth canal - nulliparous women

A

Passage through the birth canal is considered prolonged if it exceeds 3 hours with analgesia or exceeds 2 hours without analgesia

44
Q

Stage 2 labour - passage through the birth canal - multiparous women

A

Passage through the birth canal is considered prolonged if it exceeds 2 hours with analgesia or exceeds 1 hour without analgesia

45
Q

Stage 3 labour

A

Expulsion of placenta and foetal membranes

46
Q

Stage 3 labour - average duration

A

5-10 mins after delivery of baby.

It is considered normal up to 30 mins post delivery

47
Q

Stage 3 labour - active management if there is no expulsion of placenta and foetal membranes in adequate time frame

A

Prophylactic administration of syntometrine
Oxytocin 10 units
Cord clamping and cutting

48
Q

Movements of labour - outline the 7 movements of the foetus during delivery

A
  1. Engagement of head
  2. Descent
  3. Flexion of head
  4. Internal rotation
  5. Crowning and extension
  6. Restitution and external rotation
  7. Expulsion, anterior shoulder first
49
Q

Movements of labour - engagement of head

A

Foetal head is engaged when the widest diameter of the foetal head has entered the brim of the pelvis
- at this point 3/5ths of foetal head will have entered pelvis

50
Q

Movements of labour - descent

A

Downward passage of the presenting part through the pelvis

51
Q

Movements of labour - during descent, what is the foetal head position?

A

Occiput transverse position - this is the widest pelvic diameter available for the widest part of the baby’s head

52
Q

Movements of labour - flexion of foetal head

A

This occurs due to the shape of the bony pelvis and the resistance offered by the soft tissues

53
Q

Movements of labour - internal rotation

A

Rotation of the presenting part from its original position (transverse) to anterior position as it passes through the pelvis

54
Q

Movements of labour - crowning and extension

A

Once the foetus reaches the introits, you can see a large segment of the foetal head
Delivery of the head should be managed carefully and slowly with hands guiding but not leading the exit to prevent rapid extension of tissues and tearing

55
Q

Movements of labour - restitution and external rotation

A

Return of foetal head to normal anatomical position in relation to foetal torso

56
Q

Movements of labour - expulsion

A

Delivery of rest of baby

Anterior shoulder first

57
Q

What is a partogram? and what does it measure?

A 
Graphic representation of the progress of labour. 
Measures 
- foetal heart
- amniotic fluid
- contractions
- cervical dilatation
- descent 
- obstruction
- maternal obs
58
Q

What is used to assess foetal heart?

A

CTG

59
Q

Who needs CTG monitoring?

A

High risk pregnancy

60
Q

CTG - what is the upper trace ?

A

Foetal HR

61
Q

CTG - what is the lower trace ?

A

Uterine contraction pattern from mum

62
Q

What is the CTG interpretation pneumonic?

A

DR C BRAVADO

63
Q

CTG - Determine Risk

A

High or low ?

64
Q

CTG - Contractions

A

Comment on frequency
- how many in 10 mins?
Unable to tell strength of contraction

65
Q

CTG - Baseline RAte

A

Normal: 110-150bpm
Tachycardia: >150 bpm
Bradycardia: <110bpm

66
Q

CTG - Variability

A

Jaggedness of the line around the baseline HR
there should be lots of variability.
If there is reduced variability - think hypoxia

67
Q

CTG - Acceleration

A

Rise above the baseline
Can be present or absent
If present this is reassuring as when the uterus contracts, the foetal HR should increase

68
Q

CTG - Decelerations

A

Early
- normal and physiological in the pushing stage of labour due to head compression

Late

  • BAD
  • this is a sign of foetal hypoxia
69
Q

CTG - Overall impression

A

Is this reassuring or are you concerned?

70
Q

Analgesia options during labour

A 
Paracetamol
Diamorphine
Epidural anaesthesia 
TENS 
Entonox (gas and air)
Remifentanyl
71
Q

The umbilical cord should be clamped immediately. True or false?

A

False

  • delayed cord clamping is more beneficial.
  • immediate cord clamping reduces the RBCs an infant receives at birth
72
Q

Skin to skin contact

A

For an hour immediately after birth

73
Q

What are fontanelles?

A

Soft spot on baby head

74
Q

What shape is the anterior fontanelle?

A

Diamond

75
Q

When does the anterior fontanelle ossify?

A

Between 9 and 18 months

76
Q

The posterior fontanelle is what shape?

A

Triangular

77
Q

The occipitofrontal diameter is longer/shorter than the piparietal diameter?

A

Longer

78
Q

At the mothers pelvic inlet, which diameter of the pelvis is wider?

  • transverse diameter
  • AP diameter
A

Transverse diameter

79
Q

How should the foetus enter the pelvic cavity (what direction should the baby’s head be in)

A

Baby’s head should be transverse (facing either right of left)

80
Q

When descending through the pelvic cavity, what should happen to the foetal head?

A

It should rotate and be in a flexed position

81
Q

At the mothers pelvic outlet, which diameter is widest?

  • transverse diameter
  • AP diameter
A

AP diameter

82
Q

The baby should leave the pelvic cavity in which position?

A

OA (occipitoanterior)

83
Q

During delivery, the foetal head should be in flexion/extension?

A

Extension

84
Q

What is a station?

A

The distance of the foetal head from the ischial spines

85
Q

-ve station means what?

A

Head is superior to the ischial spines

86
Q

+ve station means what?

A

Head is inferior to the ischial spines

87
Q

Maternal nerve injuries during delivery - what can stretching cause?

A

Incontinence

88
Q

Maternal nerve injuries during delivery - what can stirrups cause?

A

Common peroneal nerve damage (calf)

89
Q

How can a baby get bells palsy during delivery ?

A

Due to forceps clamping around the head

Reproduction SOH (50 decks)

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