Normal Labour And Management

Question 1

What is a term gestation

Answer 1

37 weeks gestation means the baby is ready to be born

Question 2

How would you take history in patients in labour

Answer 2

How many weeks gestation
Previous pregnancy
How many babies I.e twins
Known complications
Pre existing medical, conditions
Have the waters broken - blood, smell, stool
Contractions time and often
Any urge to push

Question 3

What kind of equimpment would you broing in

Answer 3

Maternity pack
suction
ALS
lifepack
entonx
Blankets

Question 4

How do we assess if birth is imminent

Answer 4

if contractions are frequent 2 minutes
if baby is visible
If she has an urge to push
and they tell you they need to poo

Question 5

How do we know if we need to convey

Answer 5

No signs of birth imminent
Meconium or blood present
Birth imminent but no progression after 10 minutes
Pre-term before 37 weeks
Known complications

Question 6

what to do if you are staying on scene

Answer 6

Close windows and turn on heating
Make sure the mother is as comfortable as possible
Give the mother Entonox
Newborn life support area
Warm towels

Question 7

What is crowning

Answer 7

this is when the widest part of the baby’s head can be seen which stretches the perineum at this point we want the mum to pant

Question 8

How long until the baby is born

Answer 8

hopefully after the next contraction when the baby head and face is turned as this can turn into a baby going into hypoxic

Question 9

What do we need to after baby is born

Answer 9

dry the baby with the towel as much as you can for 60 seconds assessing the baby’s colour (lip, tongue), tone (crying, floppy), breathing want the baby to have a strong cry,wrap the baby with another towel,next doing skin to skin with the mother

Question 10

How do we keep newborns warm

Answer 10

Dry thoroughly
Dispose of the wet towel and wrap it in a dry towel
Put a hat on the baby
Put in a blizzard blanket
Heating on!
skin to skin if in a warm environment not if in a cold environment

Question 11

Why do newborns get cold

Answer 11

increased surface are, cant regulate their body temperature. they go through an activation of nonshivering thermogenesis

Question 12

What do we do the cord care and how do we do it

Answer 12

clamp and cut the cord when the cord when the cord has gone all white,when clamping we do it 5cm away from the babys umbilicus and another 5 cm away.

Question 13

What is the third stage and retained placenta

Answer 13

delivering the placenta normally this takes within 20 minutes or up to a hou

Question 14

How do we deliver the placenta

Answer 14

encourage them to push, gravity - get her to stand up or squat and help out or produce Oxycontin skin to skin, breastfeed

Question 15

How much blood is normal

Answer 15

200 to 300 ml is normal this is called a separation bleed the placenta is embedded in the uterine wall

Question 16

what is abnormal bleeding red flag

Answer 16

when we reach 500 ml blood we estimate that it is a incu pad/sheet.This is a postpartum haemorrhage

Question 17

When do we diagnosis a PPH

Answer 17

Blood loss of 500 mls or more and any sings of shock 24 hours after birth

Question 18

what are the cause of PPH

Answer 18

TONE – Lack of tone of the uterus prevents the vascular placental interface from closing off so continues to bleed.
TISSUE – Tissue has been retained
TRAUMA – Tears caused by birth or other trauma
THROMBIN – Bleeding conditions which will likely be known by patient (very rare)

Question 19

What is the Management plan of PPH

Answer 19

primary of secondary PPH - request extra resources- uterine massage firmly rub off the uterus, check for external tears and apply pressure with swabs if required.Go to the nearest maternity