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Hugh's MD3 Women's > Normal Labour and Delivery > Flashcards

Normal Labour and Delivery Flashcards

1
Q

What is labour?

A

The onset of regular, painful uterine contraction with cervical effacement and dilation

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2
Q

What is cervical effacement and dilation?

A

Tubal cervix is progressively shortened prior to dilation

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3
Q

When does labour end?

A

Full cervical dilation at 10cm

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4
Q

What are the stages of labour?

A

Latent
Active
Delivery

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5
Q

What is the latent phase?

A

Slow progress to full cervical effacement and 3cm dilation, variable duration

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6
Q

What is spurious labour?

A

Painful regular contraction not associated with cervical change

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7
Q

What is rupture of membrane?

A

Fused chorion and amnion constitute “the membrane”

- rupture can occur spontaneously or artificially

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8
Q

Why artificially rupture membrane?

A

Induce production of hormones to induce/augment the progress of labour

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9
Q

What does low amnionic fluid indicate?

A

Chronic placenta insufficiency?

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10
Q

What can you tell from the appearance of AF?

A

Passage of meconium

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11
Q

What are the pattern of contractions?

A

Shortening interval

Lengthening of contraction

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12
Q

What foetal factors do you consider?

A

Size

Lie and presentation

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13
Q

What are the presentations?

A

Cephalic (head first)
Breach (bottom first)
Cord first

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14
Q

What is the lies?

A

Transverse, oblique, longitudinal

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15
Q

What is the attitude?

A

Position of the head, flexion vs extension

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16
Q

What is the passage?

A

Bony and soft tissue of birth canal

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17
Q

What is chorioamnionitis?

A

Infections of placental membrane and placenta

18
Q

What do you observe in the mother during delivery?

A

Temp
BP, pulse
Pain and emotional control

19
Q

What are the pain relief options?

A

Non pharmacological
- Massage, relaxation/breathing techniques, position change

Pharmacological

  • Inhalational agents - NO
  • Systemic analgesics - Opioids
  • Neuraxial analgesia - epidural, spinal/CSE
  • Local - pudendal nerve block, perineal infiltration
20
Q

Why do a combined spinal/epidural?

A

Strong start off with the spinal

Then leave the catheter in for the epidural and prolonged relief

21
Q

What happens to foetal blood flow during contractions?

A

Reduces by 40% during contractions

22
Q

How do you monitor the foetus during labour?

A

Auscultation

Amount and colour of amniotic fluid

23
Q

What determines the length of first stage of labour?

A

Parity

Duration of latent phase

24
Q

How do you assess maternal well being?

A 
Review history
- medical history/medications
- past OH
- Complications during preg
- GBS status, double check hep C, HIV
- Blood group
Labour history
Examination
25
Q

How do you assess foetal well being?

A

Colour and volume of amniotic fluid
auscultation of fetal heart beat or admission CTG
assess ? indication for continuous electronic fetal monitoring

26
Q

How do you assess progress of labour?

A

Progress of contractions
Vaginal exam - every 4 hours
Documented on partogram

27
Q

Routine care in normal labour consistents of what?

A 
Observations
Activity - ambulate as desired
Fluids and diet 
IV access not routine
Abx prophylaxis - if positive swab
28
Q

How long does the second stage of labour last?

A

1-2 with no epi

2-3 with epi

29
Q

What is caput?

A

Two plates of bone coming into contact with each other

30
Q

What is moulding?

A

Two plates of bone overlapping

31
Q

What are the diameters depending on attitude?

A

Suboccipitobregmatic diameter - 9.5
Occipitofrontal - 11cm
Supraoccipitomental (Brow) - 13.5cm
Face presentation - 9.5cm

32
Q

What are the narrowest diameter?

A

Ischial spines

33
Q

Why does the baby turn?

A

Because the ischial spine in the midpelvis is narrower than the AP diameter at that point

34
Q

In what order does the body come out?

A

Head
Anterior shoulder
Posterior shoulder

35
Q

What is the third stage of labour?

A

Separation and expulsion of the placenta

36
Q

How do you help expulsion of placenta?

A

Controlled cord traction

37
Q

What is a first degree tear?

A

Laceration involving perineal skin or vaginal mucosa only

38
Q

What is a secondary degree tear?

A

Extending into the submucosal tissues of the vagina or perineal muscles

39
Q

What is a third degree tear?

A

Extending to involve anal sphincter

40
Q

What is a fourth degree tear?

A

Involvement of rectum

41
Q

What is position?

A

Location of the presenting part in relation to location in maternal pelvis

Hugh's MD3 Women's (68 decks)

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