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Y3 Reproduction > Normal Labour and Puerperium > Flashcards

Normal Labour and Puerperium Flashcards

1
Q

what is labour?

A

the physiological process in which the foetus, membranes, umbilical cord and placenta are expelled from the uterus

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2
Q

what are the three options for where a patient can give birth?

A

consultant led unit
midwife led unit
home

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3
Q

what is Ferguson’s reflex?

A

the foetal distension onto the cervix stimulates neuroendocrine responses, resulting in oxytocin production

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4
Q

what is the role of progesterone in labour?

A

keeps the uterus settled

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5
Q

what is the role of oestrogen in labour?

A

causes the uterus to contract

promotes prostaglandin production

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6
Q

what is the role of oxytocin in labour?

A

initiates and sustains contractions

promotes prostaglandin release

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7
Q

where is oxytocin synthesised?

A

pituitary

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8
Q

what is the role of liquor?

A

nurtures and protects the foetus
facilitates movement

also known as amniotic fluid

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9
Q

what does it mean if a baby is born in a caul?

A

still in the membranes

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10
Q

what is cervical tissue made of?

A

collagen, smooth muscle and elastin held together by ground substance

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11
Q

what causes reduced firmness of the cervix?

A

increased hyaluronic acid

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12
Q

what histological changes are involved in cervical ripening?

A

decrease in collagen fibre alignment and strength

decrease in tensile strength of the cervical matrix

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13
Q

what scoring system is used to determine if it is safe to induce labour?

A

Bishop’s score

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14
Q

what are the five elements included in the Bishop’s score?

A 
position 
consistency 
effacement 
dilatation 
foetal station
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15
Q

what do the results of the bishop’s score mean?

A

higher score = more likely that induction will be successful

> 8 = good
4 or less = cervix needs ripening

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16
Q

what are the two phases of the first stage of labour?

A

latent phase - up to 4cm dilated

active phase - from 4cm to full dilation (10cm)

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17
Q

what occurs in the second stage of labour?

A

delivery of the baby

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18
Q

when is the second stage of labour considered to be prolonged in nulliparous women?

A

> 3 hours with regional analgesia

> 2 hours without

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19
Q

when is the second stage of labour considered to be prolonged in multiparous women?

A

> 2 hours with regional analgesia

> 1 hour without

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20
Q

what is the third stage of labour?

A

expulsion of placenta and membranes

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21
Q

what is the average duration of the third stage of labour?

A

ten minutes

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22
Q

when does the third stage of labour require intervention?

A

if lasting over an hour

can do this via oxytocic drugs, controlled cord traction or surgical removal

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23
Q

what are Braxton hicks contractions?

A

tightening of the uterine muscles to prepare the body for birth

irregular, do not increase in frequency or intensity

relatively painless

24
Q

when do Braxton hicks contractions occur?

A

can start as early as six weeks

usually felt more in the third trimester

25
Q

what can relieve Braxton hicks contractions?

A

ambulation

26
Q

what causes true labour contractions?

A

oxytocin stimulating contraction of the uterus

27
Q

what is true labour?

A

when the timing of contractions becomes evenly spaced and the time between them gets shorter and shorter

duration and intensity of contractions also increases

28
Q

what do contractions achieve?

A

tighten the top of the uterus, pushing the baby into the birth canal - this also promotes thinning of the cervix

29
Q

what is normal frequency of contractions?

A

3-4 in 10 minutes

30
Q

what is a normal duration for contractions?

A

initially 10-15 seconds

can build up to 45

31
Q

what are the three grades of intensity of contractions?

A

mild
moderate
strong

32
Q

name three types of pelvis

A

anthropoid
gynaecoid
android

33
Q

which pelvic shape is the most suitable for birth?

A

gynaecoid

34
Q

what is a partogram?

A

a graphic record of key data used to assess the progress of labour

35
Q

what are the seven cardinal movements involved in labour?

A 
engagement 
decent 
flexion 
internal rotation 
crowning + extension 
external rotation 
expulsion
36
Q

what is engagement?

A

passage of the widest diameter of the presenting part to a level below the pelvic inlet

37
Q

what is decent?

A

downward passage of the presenting part through the pelvis

38
Q

what is internal rotation?

A

rotation of the presenting part to the anterior position as it passes through the cervix

39
Q

what occurs in crowning and extension n?

A

brings the base of the occiput into contact with the pubic symphysis

40
Q

when does crowning occur?

A

when the foetus has reached the level of the introitus

41
Q

what is external rotation?

A

return of the foetal head to the correct anatomical position

aka restitution

42
Q

what is expulsion?

A

delivery of the rest of the foetal body

43
Q

what is crowning?

A

the appearance of a large segment of foetal head at the Introitus

44
Q

what may be required to prevent trauma during crowning?

A

episiotomy

45
Q

why is delayed cord clamping beneficial?

A

higher RBC to vital organs - less neonatal anaemia

46
Q

what should be administered as prophylaxis in the third stage of labour?

A

syntometrine or oxytocin

47
Q

what is the main method for placental separation?

A

Matthew Duncan

48
Q

what is a normal amount of blood loss in labour?

A

<500mls

>500 = abnormal 
>1000 = very significant
49
Q

what is puerperium?

A

a period of repair and recovery after delivery where tissues return to the non pregnant state

50
Q

how long does puerperium take?

A

six weeks

51
Q

what is lochia?

A

vaginal discharge containing blood, mucous and endometrial castings after birth

52
Q

what is lochia rubra?

A

fresh red discharge

3-4 days after delivery

53
Q

what is lochia serosa?

A

browny-red watery discharge

4-14 days after deliver y

54
Q

what is lochia alba?

A

yellow discharge

10-20 days after delivery

55
Q

what are the three types of lochia?

A

rubra
serosa
alba

Y3 Reproduction (49 decks)

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