Normal Labour And Puerperium Flashcards

1
Q

Effect of oestrogen on uterus?

A

Makes it contract

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2
Q

Effect of progesterone on uterus ?

A

Keeps it settled

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3
Q

Oxytocin a relationship with contractions?

A

Initiates and sustains contractions

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4
Q

What is the fergusons reflex?

A

Neuroendocrine reflex comprising self-sustaining cycle of uterine contractions initiated by pressure at cervix or vaginal wall

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5
Q

What is bishops score and what does it comprise of?

A
Method of determining if safe to induce labour.
Position 
Consistency
Affacement 
Dilatation
Station in pelvis
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6
Q

What happens in 1st latent stage of labour?

A

Mild irregular uterine contractions
Cervix shortens and softens
Duration variable

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7
Q

What Happens in 1st active phase of labour?

A

4cm to full dilatation
Slow decent of presenting part
Contractions become more rhythmic and stronger

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8
Q

What happens in 2nd stage of labour?

A

Complete dilatation of cervix (10cm) to delivery of baby
Nullparous - up to 3hrs with analgesia and 2 hrs without
Multiparous- up to 2 hrs with analgesia and 1 hr without

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9
Q

What happens in the 3rd stage of delivery?

A

Delivery of baby to expulsion of placenta and fetal membranes.
Lasts about 10mins - if longer than 1 hour, removal under GA

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10
Q

What changes happen to cervix?

A

Softening

Ripening

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11
Q

What causes cervical softening?

A

Increase in hyaluronic acid - increase in molecules among collagen fibres.
Decrease in bridging among collagen fibres -> decreases firmness of cervix

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12
Q

What are Braxton-hicks contractions?

A

Tightening of uterine muscles - false labour.
Felt in 2nd and 3rd trimester.
Irregular, don’t increases in frequency or intensity.
Quite painless.

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13
Q

What hormone stimulates contractions?

A

Oxytocin

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14
Q

What happens to contractions and labour progresses?

A

Evenly spaced but get closer together.

Get more intense and painful.

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15
Q

Where the contractions originate?

A

Pacemaker region of tubal Ostia

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16
Q

What is the most suitable pelvis shape?

A

Gynaecoid pelvis

17
Q

What is an anthropoid pelvis?

A

Oval shaped inlet with large anterio-posterior diameter and smaller transverse diameter

18
Q

What is an android pelvis?

A

Triangular/ heart shaped inlet and is narrower from front.

Afro-Caribbean

19
Q

What are the cardinal movements?

A
Engagement
Decent
Flexion
Internal rotation 
crowing and extension 
Restitution and external rotation 
Expulsion
20
Q

When does expulsion of placenta occur?

A

About 5-10 mins after delivery - normal up until 30 mins

21
Q

Analgesic option during delivery?

A
Paracetamol/ co-codamol
TENS
Entomox
Diamorphine
Epidural
Remifentanyl
Combined spinal/ epidural
22
Q

Normal blood loss during delivery?

23
Q

Abnormal blood loss during delivery ?

24
Q

Significant blood loss during delivery?

25
What is puerpeurium?
Period of Repair and recovery
26
How long does it take for tissues to return to non-pregnant state?
6 weeks
27
What is Lochia?
Vaginosis discharge containing blood, mucus and endometrial castings
28
Rubra Lochia?
Fresh red
29
Serosa lochia?
Brownish red, watery
30
Alba Lochia?
Yellow
31
How long after delivery does flood stained discharge last?
10-14 days
32
How long does it take for endometrium to regenerate after delivery?
About a week
33
What is lactation initiated by?
Placental expulsion
34
For lactation, what are the change in hormones?
Decrease in oestrogen Decrease in progesterone Prolactin is maintained