Normal Labour Flashcards
What is labour?
The process in which the fetus, placenta and membranes are expelled via the birth canal
At what gestation is labour normal?
37-42 weeks
What are the triggers for the initiation of labour?
Paracrine and autocrine signals generated by maternal, fetal and placental factors which interplay
Which physiological changes must occur to allow for expulsion of the fetus?
Softening of the cervix, myometrium tone changes to allow for coordinated contractions and progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate
What happens during stage 1 of labour?
- complete when cervix is fully dilated
- length of this stage varies
- progress is usually 0.5-1 cm per hour
What happens during stage 2 of labour?
- From full cervical dilatation to the birth of the baby
- passive and active stages
- Primagravida birth would be expected within 2 hours of active second stage
- Multigravida birth would be expected within one hour of the active second stage
What happens during the 3rd stage of labour?
- The time from the birth of the baby to the expulsion of the placenta and membranes
- active management and physiological managment
- Prolonged third stage: 30 minutes for active and 60 minutes for physiological managment
How is the progress of labour monitored?
Maternal obs, fetal obs, vaginal examination, monitoring of liquor, auscultation of the fetal heart, palpation of uterine muscle contractions and external signs (e.g. rhomboid of michaelis and anal cleft line)
Name the steps in the 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
What are the analgesia options for labour?
- Breathing, massage, TENS, paracetamol and dihydrocodeine
- Water
- Entonox (NO and O2)
- Opioids
- Remifentanil patient controlled analgesia
- Epidural
