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Normal labour Flashcards

1
Q

Is labour normally induced or spontaneous?

A

Spontaneous

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2
Q

When does birth normally take place?

A

37-42 weeks gestation

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3
Q

What are some key changes we know must occur for normal spontaneous birth?

A

Cervix soften
Myometrial tone changes to allow coordinated contractions
Progesterone decreases while oxytocin and prostaglandins increase to initiate labour

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4
Q

What are the 3 phases of the first stage of labour?

A

Latent
Active
Tansition

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5
Q

What are some characteristics of the latent phase?

A

First
Can be longest
Irregular contractions
Cervical dilation up to 4cm

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6
Q

Name some characteristics of the active phase.

A

8-12 hours
Regular painful contractions
Cervix 4-10cm

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7
Q

What are some characteristics of the transition phase?

A

Cervix 8-10cm
Possible physical changes like shaking, vomiting or need to empty bowels
May express inability to cope

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8
Q

During which stage does the cervix dilate fully to birth?

A

Second

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9
Q

What may indicate second stage?

A

Fully dilated
See presenting part visible
Expulsive contractions or maternal effort after encouragement

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10
Q

What categorises the third stage?

A

From birth of baby to expulsion of placenta and membranes

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11
Q

What does Nulliparous mean?

A

Woman has not experienced live birth

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12
Q

What does multiparous mean?

A

Given birth multiple times

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13
Q

What is the function of flexion in the mechanism of labour?

A

Smaller diameter presenting to aid navigation through the pelvis

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14
Q

What is internal rotation?

A

Leading part is pushed down towards pelvic floor and diaphragm resists, causing rotation

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15
Q

Describe crowning and extension.

A

Head is guided by pelvic floor, turns 45*, comes under pubic arch and extends, does not recede

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16
Q

What is restitution?

A

Baby turns back to face position it was in utero

17
Q

Describe external rotation of the head and internal rotation of shoulders.

A

Shoulders catch up with way head is facing.

Cranium lateral

18
Q

Describe cephalic fetal lie.

A

Head pointing to birth canal

Basically upside down to us

19
Q

Describe breech fetal lie.

A

Arse pointing towards birth canal

20
Q

Describe transverse fetal lie.

A

Head and arse point laterally

21
Q

How is the fetal heart monitored?

A

Intermittent auscultation

Continuous monitoring

22
Q

Which devices are used to auscultate the fetal heart?

A

Pinards stethoscope

Hand held dopplar (amplifies)

23
Q

What is used for continuous fetal heart monitoring?

A

Cardiotocograph (CTG)
Paddles put on woman’s abdomen
Measure fetal heart and contractions

24
Q

What is a normal fetal heart rate?

A

110-160

High variability and accelerations

25
Q

What are some ways the mother is monitored during birth?

A 
Abdominal palpation
Vaginal exam
Monitoring of liquor
Palpation of contractions 
External signs
26
Q

What are 2 external signs used to monitor the mother?

A

Rhomboid of Michaelis

Anal cleft lign

27
Q

How is liquor used to monitor labour?

A

Clear, straw colour or slightly pink all normal and good indication
Look out for meconium or bloods

28
Q

What is the rhomboid of michaelis?

A

Rhomboid shape obvious at tail bone

Displaced pelvic bone making way for baby’s head

29
Q

What are some good non-pharmacological options for support through labour?

A 
Position and mobility
Breathing and hypnobirthing
Massage
Aromatherapy
TENS
30
Q

What is multiple gestation?

A

Pregnancy with more than one embryo

31
Q

What are dichorionic diamniotic twins?

A

Each baby has a separate placenta and amniotic sac

32
Q

What are monochorionic diamniotic twins?

A

Both babies share a placenta but have separate amniotic sacs

33
Q

What are monochorionic monoamniotic twins?

A

Each baby shares amniotic sac and placenta

Reproduction (25 decks)

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