Normal labour

Question 1

a rise in what hormones trigger labour?

Answer 1

oxytocin and prostaglandins

Question 2

a decrease in what hormone triggers labour?

Answer 2

progesterone

Question 3

what 3 factors initiate labour?

Answer 3

progesterone decreases and oxytocin and prostaglandins increase
cervix softened
myometrial tone changes to allow for coordinated contractions

Question 4

by how much per hour should the cervix dilatate during the first stage of labour?

Answer 4

0.5cm - 1cm per hour

Question 5

describe the first stage of labour.

Answer 5

latent first stage:
- intermittent, irregular periods of painful contractions. some cervical effacement and dilation of up to 4cm

first stage:
- regular contractions that result in effacement of the cervix and cervical dilatation from 4cm

Question 6

at what diameter is the cervix fully dilated?

Answer 6

10cm

Question 7

what is the average length of the first stage of labour in a primigravida and multigradivida?

Answer 7

primigravida: approx 8 hours (no longer than 18hours)

multigravida; approx 5 hours (no longer than 12 hours)

Question 8

according to WHO, when is the first stage of labour established?

Answer 8

cervix is dilated to 5cm

Question 9

where does contractions begin?

Answer 9

the fundus and moves down and across

Question 10

what is stage 2 of labour?

Answer 10

from fully dilated cervix to the delivery of the baby

Question 11

what are 2 physical signs used for assessing progress of labour?

Answer 11

rhomboid of michaelia

anal cleft line

Question 12

how can foetal heart be monitored during pregnancy?

Answer 12

doppler
cardiotocography
pinards

Question 13

how can you monitor and assess progress of labour?

Answer 13

vaginal examination
foetal heart monitoring 
abdominal palpation 
palpation of uterine contractions
assessing liquor vol, smell, colour
BP, urinalysis, temp, resp, urine output 
external signs

Question 14

what are the cardinal movements of labour?

Answer 14

engagement
descent
flexion
internal rotation
extension
external rotation
expulsion

Question 15

what is the normal lie, presentation and position of baby in normal labour?

Answer 15

lie = longitudinal 
presentation = cephalic 
position = right or left occiput anterior

Question 16

what is the presenting part of baby in normal labour?

Answer 16

anterior parietal bone

Question 17

give 3 methods of drug free pain relief during pregnancy?

Answer 17

breathing
massage
TENS (transcutaneous electrical nerve stimulation)
consider maternal position, and mobility

Question 18

what are the types of pain relief given during labour?

Answer 18

entonox (inhalation of nitrous oxide)
epidural 
remifentanil (patient controlled)
paracetamol, dihydrocodeine 
opioids (morphine, pethidine, diamorphine)