Normal Labour

Question 1

what is labour?

Answer 1

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

Question 2

what are different levels of care for giving birth?

Answer 2

consultant led unit

midwife led unit

homebirth

Question 3

what is a birth plan?

Answer 3

record of what woman would like to happen during her labour

(encourgaed but not necessary)

Question 4

what occurs durign the initaion of labour?

Answer 4

change in oestrogen and progesterone

fetal adrenals and pituitary hormones

myometiral stretch

fergusons reflex

Question 5

what is fergusons reflex?

Answer 5

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

Question 6

what hormonal factors are involved in labour?

Answer 6

prgesterone

oestrogen

oxytocin

Question 7

how does progesterone influence labour?

Answer 7

keeps uterus settled

prevents formation of gap junctions

hinders contractability of myocytes

Question 8

how does oestrogen influence labour?

Answer 8

makes uterus contract

Question 9

how does oxytocin influence labour?

Answer 9

initiates and sustains contractions

acts on decidual tissue to promote prostaglandin release

Question 10

what happens to the number of oxytocin receptors during pregnancy?

Answer 10

they increase

Question 11

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

Answer 11

pulmonary surfactant

SRC1,2

Question 12

an increase in foetal cortisol stimulates what?

Answer 12

maternal oestriol

Question 13

what does it mean to be born in a caul?

Answer 13

within the bag of fluid as membranes didnt rupture

really rare

Question 14

when can rupture of the membranes occur?

Answer 14

pre term

pre labour

first stage

second stage

Question 15

the cervix is mainly made up of which tissues?

Answer 15

collagen types 1-4

smooth muscle

elastin held together by connective tissue ground substance

Question 16

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

Answer 16

hyaluronic acid

Question 17

what is Bishops score?

Answer 17

estimates likelihood of woman going into labour

dilation

effacement

station

consistency

postion

Question 18

how many satges of labour are there?

Answer 18

three

Question 19

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

Answer 19

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

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

Question 20

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

Answer 20

1-2cm per hour

Question 21

what is the second stage of labour?

Answer 21

full dilation (10cm)

delivery of baby

Question 22

what is considered prolonged second stage of labour?

Answer 22

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

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

Question 23

what is the third stage of labour?

Answer 23

explusion of the placenta

Question 24

what are two managements options for delivery of the palcenta?

Answer 24

exeptive- spontaneous natural delivery

active- given oxytocic drugs to stimulate contractions and delivery

Question 25

how long after birth is the placenta usually delivered?

Answer 25

usually around ten minutes but can take up to an hour

Question 26

what are braxton hicks contractions?

Answer 26

'false labour' false sensation of real contractions

Question 27

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

Answer 27

power passage passenger

Question 28

what analgesic options are availbale during labour?

Answer 28

entonox diamorphine epidural

Question 29

what is used to record the progress of labour?

Answer 29

Partogram

Question 30

what is recorded on partogram?

Answer 30

foetal heart amniotic fluid cervical dilation descent contractions obstruciton- moulding maternal obvs

Question 31

what are the 7 cardinal movements?

Answer 31

engagement descent flexion: chin to chest internal rotation crowning and extension restitution (babies head rotates to align w shoulders) expulsion

Question 32

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

Answer 32

delayed cord clamping skin to skin contact

Question 33

what is puerperium?

Answer 33

period of repair and recovery of mum 6 weeks following birth

Question 34

what initiates lactation?

Answer 34

placental expulsion decrease in oestrogen and progesterone