Normal labour Flashcards
What is potential labour?
The transitional phase between false and true labour
What are the 3 signs of labour?
- Regular contractions
- Rupture of membranes
- Mixed blood and mucus discharge (show)
- Any complication like antepartum haemorrhage
What is show
?
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
What analgesia do we give uncomplicated labour?
- Epidural anaesthesia
2. Pethidine as well
Why should the mom lie on her side and not her back?
To prevent postural hypotension as lying on her back can lead to compression of her superior vena cava
What is the typical heart rate of the fetus?
120-160 beats per minute without decelerations
What does green coloured Amniotic fluid signify?
Freshly meconium stained
What does brown/yellow amniotic fluid signify?
Old meconium
How often do we count the contractions?
Every 10 minutes
How many contractions can we expect every 10 minutes?
About 3-4 and lasting 45-60 seconds each
What do you need to look and feel for in the vaginal examination?
- Feel for the ruptureof the membranes and ascertain the time it happened
- Determine the cervical dilation and effacement
- Feel for the fetal presentation
- Determine the pelvic shape and size
What are the two phases of the first stage of labour?
- Latent phase
2. Active phase
What is the latent phase of labour?
Effacement of the cervix where the cervix will thin and shorten and become 3-4 cm
- primigravida: 8 hours
- multigravida: 6 hours
What is the active phase of labour?
Dilation of the cervix to 4-10 cm
- primigravida at 1 cm per hour
- multigravida at 1,5 cm per hour
What are the two phases of the second stage of labour?
- Phase 1
- this is from full dilatation of the cervix to the presenting part reaching the pelvic floor - Phase 2
- entails the presenting part reaching the pelvic floor muscles and triggering the ferguson reflex
What is the third stage of labour?
This is between the delivery of the baby and delivery of the placenta
What are the injuries to the baby at stage 2, phase 2 of labour?
Foetal asphyxia risk and moulding
What are the risks of a prolonged active phase in stage 1?
Risk of infection,fetal distress and rupture of the uterus
When would we consider giving the patient IV fluids?
- If there is prolonged labour of 4-6 hours
- Ketonuria
- Abnormal fetal heart patterns
When does the Ferguson reflex usually occur?
In phase 2 of stage 2-when the head reaches the pelvic floor
What are the clinical characteristics of stage 2, phase 2?
- 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
How long does the third stage usually develop?
5-10 minutes
What is an episiotomy?
It is an incision through the perineal muscles just before delivery to shorten the duration of stage 2 in primi
How do we suture an episiotomy?
You first make a suture
