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11- Reproduction > Normal Labour > Flashcards

Normal Labour Flashcards

1
Q

what is labour?

A

physiological process in which the foetus, membranes, umbilical cord and placenta are expelled from the uterus

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2
Q

what are different levels of care for giving birth?

A

consultant led unit

midwife led unit

homebirth

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3
Q

what is a birth plan?

A

record of what woman would like to happen during her labour

(encourgaed but not necessary)

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4
Q

what occurs durign the initaion of labour?

A

change in oestrogen and progesterone

fetal adrenals and pituitary hormones

myometiral stretch

fergusons reflex

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5
Q

what is fergusons reflex?

A

the reflex initaiting cycle of uterine contractions in repsonse to pressure at cervix or vaginal walls

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6
Q

what hormonal factors are involved in labour?

A

prgesterone

oestrogen

oxytocin

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7
Q

how does progesterone influence labour?

A

keeps uterus settled

prevents formation of gap junctions

hinders contractability of myocytes

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8
Q

how does oestrogen influence labour?

A

makes uterus contract

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9
Q

how does oxytocin influence labour?

A

initiates and sustains contractions

acts on decidual tissue to promote prostaglandin release

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10
Q

what happens to the number of oxytocin receptors during pregnancy?

A

they increase

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11
Q

what other hormones are released from baby and thought to cause inflammatory like response in uterus?

A

pulmonary surfactant

SRC1,2

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12
Q

an increase in foetal cortisol stimulates what?

A

maternal oestriol

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13
Q

what does it mean to be born in a caul?

A

within the bag of fluid as membranes didnt rupture

really rare

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14
Q

when can rupture of the membranes occur?

A

pre term

pre labour

first stage

second stage

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15
Q

the cervix is mainly made up of which tissues?

A

collagen types 1-4

smooth muscle

elastin held together by connective tissue ground substance

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16
Q

an inc in what allows realignment and change in position of the cervix i.e. dilation?

A

hyaluronic acid

17
Q

what is Bishops score?

A

estimates likelihood of woman going into labour

dilation

effacement

station

consistency

postion

18
Q

how many satges of labour are there?

A

three

19
Q

what are the two phases of the first satge of labour?

A

latent phase → up to 3-4cm dialtion, mild contractions hours apart

active stage → 4-10cm dilation, regular contractions every 10-15 mins

20
Q

what is the normal progression of dilation during active phase in first stage of labour?

A

1-2cm per hour

21
Q

what is the second stage of labour?

A

full dilation (10cm)

delivery of baby

22
Q

what is considered prolonged second stage of labour?

A

Nulliparous women: >3hrs w analgesia, >2 without

Multiparous women: >2hrs w analgesia, >1 without

23
Q

what is the third stage of labour?

A

explusion of the placenta

24
Q

what are two managements options for delivery of the palcenta?

A

exeptive- spontaneous natural delivery

active- given oxytocic drugs to stimulate contractions and delivery

25
Q

how long after birth is the placenta usually delivered?

A

usually around ten minutes but can take up to an hour

26
Q

what are braxton hicks contractions?

A

‘false labour’

false sensation of real contractions

27
Q

what are the three P’s to consider during labour?

A

power

passage

passenger

28
Q

what analgesic options are availbale during labour?

A

entonox

diamorphine

epidural

29
Q

what is used to record the progress of labour?

A

Partogram

30
Q

what is recorded on partogram?

A

foetal heart

amniotic fluid

cervical dilation

descent

contractions

obstruciton- moulding

maternal obvs

31
Q

what are the 7 cardinal movements?

A

engagement

descent

flexion: chin to chest

internal rotation

crowning and extension

restitution (babies head rotates to align w shoulders)

expulsion

32
Q

immediately following birth of baby what are the best next steps assuming baby is healthy?

A

delayed cord clamping

skin to skin contact

33
Q

what is puerperium?

A

period of repair and recovery of mum 6 weeks following birth

34
Q

what initiates lactation?

A

placental expulsion

decrease in oestrogen and progesterone

11- Reproduction (19 decks)

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