Normal Labour and Delivery

Question 1

what is preterm labour?

Answer 1

Preterm: ≥20wks to ≤36+6 wk GA

Question 2

what is term labour?

Answer 2

Term: 37-41+6 wk GA

Question 3

what is post term?

Answer 3

Postterm: ≥42 wk GA

Question 4

what is false labour?

Answer 4

False Labour (Braxton-Hicks): irregular painful contractions w/unchanged intensity w/long intervals; no cervical dilation, effacement, or descent → relieved via rest or sedation

Question 5

what are the signs of placenta delivery?

Answer 5

Gush of blood, lengthening of cord, the uterus becomes firmer and fundus rises

Question 6

what mx should you include in the active phase of stage 1?

Answer 6

1. monitor mom vitals + admit
2. offer analgesias
3. intermittent fetal auscultation
4. cervical exams
5. consider amniotomy if ROM not occured by 6cm

Question 7

what mx should you include in the pushing stage?

Answer 7

1. intermittent fetal auscultation
2. support mom
3. catch baby

Question 8

what are the 4 signs of the placenta being delivered?

Answer 8

1. cord extension
2. blood gush
3. fundus rises
4. fundus hardens

Question 9

how do you mx stage 3 of labour?

Answer 9

1. IV oxytocin
2. catch placenta
3. inspect placenta for completeness and 2 arteries and 1 vein
4. consider manual removal of placenta if no removal within 30min

Question 10

what are the cardinal movements of labour for fetus?

Answer 10

1. decent/engagement - into the pelvic inlet (measure station)
2. flexion - chin tucking
3. internal rotation - shoulders to widest portion of pelvis
4. extension - head going out under pubic bone, and untucking chin
5. external rotation - shoulders align with pelvic outlet to move out under the pubic bone
6. expulsion - rest of body delivered

Question 11

what do you do in stage 4 of labour?

Answer 11

recovery period of 1 hour
1. monitor mom for vitals and bleeding - re: PPH and DIC
2. repair lacerations