Normal Labour Flashcards
What is normal labour?
The process in which the foetus, placents and membranes are expelled via the birth canal
When does normal labour take place?
37-42 weeks gestation
What are the key physiological changes required in order for the expulsion of the foetus to occur?
Cervix softens
Myometrial tone changes to allow for coordinated contractions
Progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate
What marks the end of the first stage of labour?
Complete when cervix is fully dilated
What is the anticipated progress of cervical dilation during labour?
0.5 – 1.0 cm per hour
What is stage 2 of labour?
From full cervical dilatation to the birth of the baby
What are the types of second stage of labour?
Passive
Active
When would primigravida birth be expected after active second stage of birth? Multigravida?
Within 2 hours
Within 1 hour
What is the third stage of labour?
The time from the birth of the baby to the expulsion of the placenta and membranes
Progress and monitoring in pregnancy
Maternal observations Abdominal palpation Vaginal examination Monitoring of liquor Auscultation of the fetal heart Palpation of uterine muscle contractions
Mechanism of labour
Descent Flexion Internal rotation of the head Crowning and extension of the head Restitution Internal rotation of the shoulders External rotation of the head Lateral flexion
Analgesia in labour
Breathing, massage, TENS, paracetamol and dihydrocodeine
Water
Entonox (inhalational nitrous oxide and oxygen)
Opioids (morphine, diamorphine, pethidine)
Remifentanil patient controlled analgesia
Epidural
Consider maternal position and mobility as means of reducing pain and facilitating progress in labour
