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REPRODUCTION and sexual health > normal labour and puerperium > Flashcards

normal labour and puerperium Flashcards

1
Q

what is labour?

A

a physiological process during which the fetus, membranes, umbilical cord and placenta are expelled from the uterus.

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2
Q

what are the 3 main factors involved in labour?

A

POWER- of the contractions
PASSAGE- maternal pelvis
PASSENGER- fetus

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3
Q

what hormones causes contractions?

A

oestrogens and oxytocin

these also cause prostaglandin release

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4
Q

what hormone initiates and sustains contractions?

A

oxytocin

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5
Q

what causes the initiation of labour?

A

change in oestrogen:progesterone ratio

fetal hormones

myometrial stretch

mechanical stretch of cervix and stripping of fetal membranes
fergusons reflex

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6
Q

what is involved in the first stage of labour?

A

there is a latent and active phase

latent phase- mild irregular uterine contraction, cervix shortens and softens, and may last a few days

active- 4cm to full dilation, slow decent of presenting part. contractions become more rhythmic and stronger

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7
Q

what is involved in the second stage of labour?

A

from complete dilation of cervix (10cm) to delivery of baby

this is considered prolonged of more then 3 hours in somebody who hasnt had a baby

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8
Q

what is involved in the third stage of labour?

A

delivery of baby to explusion of placenta

average duration is 10 mins

can wait for placenta to deliver itself or can give oxytocin to help

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9
Q

same some cervical changes which occur during labour?

A

cervical softening- decrease in firmness

cervical ripening-decrease in collagen strength and allignment

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10
Q

what are braxton hicks contractions?

A

tightening of uterine muscles

“false labour”

they are irregular and dont increase in frequency or intensity and are relatively painless

often felt in second or 3rd trimester

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11
Q

what are true labour contractions?

A

occur when oxytocin is releasedn which stimulates uterus to contract

contractions are evenly spaced and the time between them gets shorter and shorter

they get more intense and painful over time

they tighten top part of uterus , puchins baby down and out.

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12
Q

what type of muscle is uterine muscle and where is it most dense?

A

smooth muscle

most dense at fundus of uterus

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13
Q

what is the most suitable female pelvis shape?

A

gynaecoid

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14
Q

name 3 types of female pelvis?

A

gynaecoid
anthropoid
android

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15
Q

what does liquor do>

A

nurtures and protects fetus and facilitates movement

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16
Q

what is a normal colour of membranes?

A

clear

17
Q

what does red/pink liquor indicate?

A

bleed

18
Q

what does green liquor indicate?

A

meconium

baby may have passed meconium in utero- this can cause fetal distress- infection- breathing problems

19
Q

what is a normal fetal positon

A

longitudinal lie

20
Q

what is crowning?

A

appearance of a large segment of fetal head at the introitus

labia are stretched to full capacity

burning and stinging feeling for mother

21
Q

name 5 things used to help describe the cervix?

A 
effacement-softening
dilatation
firmness
position
level of presenting part
22
Q

what score do you use to assess whether it is safe to induce labour?

A

Bishop’s score

23
Q

what are the analgesia options during labour?

A 
paracetamol/ co-codamol
TENS
entonox
diamorphine
epidural- very popular
spinal?
24
Q

what is a normal volume of blood loss during labour?

A

500mls or less

25
Q

what is an abnormal volume of blood loss during labour?

A

more than 500ml

26
Q

what are the 3 classic signs of indicate placental separation?

A

uterus contracts, hardens and rises

umbilical cord lengthens prematurely

gush of blood

27
Q

what is puerperium?

A

period of repair and recovery

this can take 6 weeks

uterine involution
endometrium regenterates by end of week

REPRODUCTION and sexual health (30 decks)

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