Normal labour

Question 1

What is potential labour?

Answer 1

The transitional phase between false and true labour

Question 2

What are the 3 signs of labour?

Answer 2

1. Regular contractions
2. Rupture of membranes
3. Mixed blood and mucus discharge (show)
4. Any complication like antepartum haemorrhage

Question 3

What is show

?

Answer 3

The mucous plug that consists of mucus and bright red blood as the mucus plug separates from the opening of the cervix
-about 15-20 cm comes out

Question 4

What analgesia do we give uncomplicated labour?

Answer 4

1. Epidural anaesthesia

2. Pethidine as well

Question 5

Why should the mom lie on her side and not her back?

Answer 5

To prevent postural hypotension as lying on her back can lead to compression of her superior vena cava

Question 6

What is the typical heart rate of the fetus?

Answer 6

120-160 beats per minute without decelerations

Question 7

What does green coloured Amniotic fluid signify?

Answer 7

Freshly meconium stained

Question 8

What does brown/yellow amniotic fluid signify?

Answer 8

Old meconium

Question 9

How often do we count the contractions?

Answer 9

Every 10 minutes

Question 10

How many contractions can we expect every 10 minutes?

Answer 10

About 3-4 and lasting 45-60 seconds each

Question 11

What do you need to look and feel for in the vaginal examination?

Answer 11

1. Feel for the ruptureof the membranes and ascertain the time it happened
2. Determine the cervical dilation and effacement
3. Feel for the fetal presentation
4. Determine the pelvic shape and size

Question 12

What are the two phases of the first stage of labour?

Answer 12

1. Latent phase

2. Active phase

Question 13

What is the latent phase of labour?

Answer 13

Effacement of the cervix where the cervix will thin and shorten and become 3-4 cm

• primigravida: 8 hours
• multigravida: 6 hours

Question 14

What is the active phase of labour?

Answer 14

Dilation of the cervix to 4-10 cm

• primigravida at 1 cm per hour
• multigravida at 1,5 cm per hour

Question 15

What are the two phases of the second stage of labour?

Answer 15

1. Phase 1
   - this is from full dilatation of the cervix to the presenting part reaching the pelvic floor
2. Phase 2
   - entails the presenting part reaching the pelvic floor muscles and triggering the ferguson reflex

Question 16

What is the third stage of labour?

Answer 16

This is between the delivery of the baby and delivery of the placenta

Question 17

What are the injuries to the baby at stage 2, phase 2 of labour?

Answer 17

Foetal asphyxia risk and moulding

Question 18

What are the risks of a prolonged active phase in stage 1?

Answer 18

Risk of infection,fetal distress and rupture of the uterus

Question 19

When would we consider giving the patient IV fluids?

Answer 19

1. If there is prolonged labour of 4-6 hours
2. Ketonuria
3. Abnormal fetal heart patterns

Question 20

When does the Ferguson reflex usually occur?

Answer 20

In phase 2 of stage 2-when the head reaches the pelvic floor

Question 21

What are the clinical characteristics of stage 2, phase 2?

Answer 21

• mainly going to be increased pain during contractions
• patient anxious and restless
• Ferguson reflex(bearing down urge)
• no fetal head palpable above the pubic symphysis

Question 22

How long does the third stage usually develop?

Answer 22

5-10 minutes

Question 23

What is an episiotomy?

Answer 23

It is an incision through the perineal muscles just before delivery to shorten the duration of stage 2 in primi

Question 24

How do we suture an episiotomy?

Answer 24

You first make a suture