Normal Labour and the partograph

Question 1

Labour is the onset of __________ _________ __________ with progressive __________________ and _________ that terminates with the ___________ and —————-

Answer 1

painful regular contractions

cervical effacement and dilatation

delivery of the fetus and the placenta.

Question 2

Contractions in labour are usually more than ______ in ____________
Labour management is a challenge because of the ethical, social and medical interplay.

Answer 2

one

ten minutes

Question 3

Mechanism of labour initiation is _________

Answer 3

unknown

Question 4

Factors thought to be responsible for labour initiation are:

Maternal – 
            \_\_\_\_\_\_\_\_\_ release/receptors
            \_\_\_\_\_\_\_\_\_\_\_\_ release/receptors
              \_\_\_\_\_\_\_\_\_\_\_\_\_ of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

 Fetal – Related to \_\_\_\_\_\_\_\_\_\_ release from \_\_\_\_\_\_\_\_\_\_\_

Answer 4

Oxytocin; Prostaglandins

Retraction ; uterine muscles

oxytocin ; posterior pituitary gland

Question 5

Anatomy of the female pelvis

The ____________ separates the pelvis into the true/ false pelvis

Answer 5

pelvic brim/inlet

Question 6

Boarders of the pelvic brim

Anterior- __________________

Lateral-________ of ___________ , iliopectineal line and ________________

Posterior- ______________

Answer 6

Pubic symphysis

upper margins of pubic bone; ala of the sacrum

sacral promontory

Question 7

Diameters of the brim

Antero-posterior; ____cm
Transverse diameter;___cm
It has an angle of ____0 to the horizontal in the erect position.
The angle is as high as ____0 in Afro-Caribbean women

Answer 7

11

13.5

60; 90

Question 8

Pelvic Mid-cavity

Anterior boundary- ————————
Lateral boundary- pubic bone, obturator fascia, inner part of ischial bones and spines

Posterior boundary- Junction between the ______________________

Diameter is _____cm in both A-P and Transverse planes

Answer 8

middle of pubic symphysis

2nd and 3rd pieces of the sacrum

12

Question 9

Pelvic Outlet

Anterior boundary- ________________

Lateral boundary- descending rami of pubic bone, ischial tuberosity, sacrotuberous ligament

Posterior boundary- ______________

Answer 9

lower margin of symphysis pubis

last piece of sacrum

Question 10

Fetal skull

Fetal skull has ______,______,_______

Answer 10

vault, face, the base

Question 11

Fetal skull

Bones of the vault- —————,————-,————,————-

Sutures
________,________,_________, and ___________ sutures

Answer 11

parietal bone, parts of the occipital, frontal and temporal bones

Sagital, frontal, coronal and lambdoidal

Question 12

Anterior fontanelle- ??

Posterior fontanelle-??

Answer 12

Diamond

Triangle

Question 13

Stages of labour

1st stage of labour- ??

2nd stage of labour-???

3rd stage of labour- ??

Answer 13

up to full (10cm) cervical Dilatation

full cervical dilatation to delivery of fetus

delivery of fetus →delivery of placenta

Question 14

1st stage of labour-

Latent phase

A woman with at least ________________ and cervical dilatation _____________

Active phase of labour
(Cervical dilatation ___________)

Answer 14

one contraction in 10 minutes

less than 4 cm

≥4cm

Question 15

Mechanism of labour

Changes in position and attitude that the fetus undergoes while it passes through the birth canal

List them

Answer 15

FIERE
Engagement
Descent
Flexion(F)
Internal rotation (I)
Extension (E)
Restitution (R)
External rotation (E)

Question 16

Latent phase of labour
____ hours

≥___ hours = _____________
Latent phase lasting _____ hours = ___________

Active phase of labour
——-hours of active phase of labour.

Answer 16

8; 8

prolonged latent phase

≥24; false labour

12

Question 17

___________ is a graphic record of labour

Answer 17

Partogram

Question 18

Partogram Allows the __________________ against the _____________ to be instantly visualized
Frequency and strength of contractions, descent of fetal head, amount and colour of amniotic fluid, blood pressure, pulse rate and temperature are also chatted

Answer 18

rate of cervical dilatation

expected norm

Question 19

Oligohydaminos?
Polyhydraminos?

Answer 19

Less than 5cm

More than 25cm

Question 20

Fetal heart rate recording should be every _______ on the Partogram

Answer 20

30 minutes

Question 21

Amniotic fluid recording on the Partogram

At every vaginal examination record the colour of the amniotic fluid:
I: _____________
R: _____________
C: _____________
M: _____________
B: _____________

Answer 21

At every vaginal examination record the colour of the amniotic fluid:
I:Membrane intact
R: Membrane rupture
C: Membrane ruptured; clear fluid
M: Meconium-stained fluid
B: Blood-stained fluid

Question 22

Moulding recording on the Partogram

1. _____________ / (+)*
2. __________________ /(++)*
3. _______________________ / (+++)*

O*- when the _________________________.

*used to report moulding in the old WHO manual of the partogram

Answer 22

Sutures apposed

Sutures overlapped but reducible

sutures overlapped but not reducible

bones are separated and the suture can be felt easily

Question 23

Other parameters on the Partogram

Pulse rate- record every ________ and mark with a dot “●”
Temperature: record every __________
Drugs given should be documented
Blood pressure: record every ________ and mark with arrow “↕”
Protein: record whenever urine is passed

Answer 23

30 minutes

2 hours

4 hour