Normal Labour Flashcards
When does Normal Labour typically occur?
37-42 weeks gestation
How is labour initiated?
Paracrine and autocrine signals by maternal, fetal and placental factors
What physiological changes my take place to allow for expulsion of the fetus?
Cervix softens
Myometrial tone changes
Progesterone decreases whilst oxytocin and prostaglandins increase
What is stage 1 of labour?
Latent stage
Complete when cervix is fully dilate
0.5-1cm per hour
What is stage 2 of labour?
Full dilation > birth of baby
Passive and active stage
How long should stage 2 of labour take in primagravida women?
Within 2hrs of active second stage
How long should stage 2 of labour take in multigravida women?
Within 1 hr of active second stage
What is stage 3 of labour?
Expulsion of placenta and membranes
When is third stage considered prolonged?
If not completed within 30 mins with active management, 60 mins with physiological management
What is active management of the third stage?
Uterotonic drugs
Optimal cord clamping
Controlled cord traction
What is physiological management of the third stage?
Delivery by maternal effort
How is the progression of labour monitored?
Maternal observations Abdominal palpation Vaginal examination Liquor monitoring Auscultation of fetal heart (every 5 mins) Palpation of contractions
What is the mechanism of labour?
Descent (engagement) Flexion (chin into chest) Internal rotation of head Crowning Extension of head Restitution Internal rotation of shoulders External rotation of shoulders
What analgesia is given in labour?
Breathing, Massage, TENS Water Entonox Opioids Remifentanil Epidural Maternal position
