Normal Labour I Flashcards
When is full term?
Between 37 and 42 weeks
Define normal labour.
Occurs between 37 and 42 weeks
Born spontaneously
In vertex position
Mother and baby in good condition
When in a pregnancy are the three trimesters?
1st: 1-12 weeks
2nd: 13-27 weeks
3rd: 28-40 weeks
How is the estimated due date calculated?
Add 9 months + 7 days onto the 1st day of the last menstrual period
When is the puerperium? What is its significance?
Up to 6 weeks after delivery
Its when the physiological changes that have occurred during pregnancy are reversed
List the stages of labour. When do they each start and finish?
Stage 1
- latent phase: 0-3cm dilation
- active phase: 3-7cm dilation
- transition phase: 7-10cm dilation
Stage 2
- from full dilation to birth of the baby
Stage 3
- from birth of baby to delivery of placenta
What happens in stage 1: latent phase of labour?
May have ‘show’ a plug of mucus and blood which falls away from cervix opening
Irregular contractions, every 5-10 mins
Cervix effaces and dilates 0-3cm
Should be able to continue normal activities
What is effacement?
Cervix becomes thinner, softer
What happens in stage 1: active phase of labour?
Regular contractions, every 3-5 mins
Cervix dilates from 3-7cm
What happens in stage 1: transition phase of labour?
Very intense contractions, every 0.5-2 mins
Also contractions can slow
Mother gets anxious, distressed
SROM: spontaneous rupture of membranes
Dilates 7-10cm
Approximately how long do the latent, active and transition phases last?
Latent: 8-12 hrs
Active: 3-5 hrs
Transition: 0.5-2hrs
A mother should come to hospital as soon as she feels contractions. True or false?
False
During latent phase, she should stay at home.
When SROM occurs, what colour should fluid be? What if it’s not?
Clear
If it’s cloudy or yellowy-green this could be meconium passed by the baby because its passed its due date or is distressed
How frequent and what is the duration of contractions in each phase of stage 1?
Latent:
- every 5-30 mins
- last 30 secs
Active:
- every 3-5 mins
- last 1 min
Transition:
- every 0.5-2 mins
- 60-90 secs
A pregnant woman (week 40) rings you saying that she’s just passed what looks like phlegm with blood in it.
Should you tell her to come in to hospital?
No, this is the ‘bloody show’ which is normal
It is a mucus plug that is in the entrance to the cervix
Passing it indicates the cervix is beginning to dilate
A pregnant woman rings you saying she’s been having what seem like contractions. She is in week 35. The contractions are not very painful and occur very irregularly. They don’t seem to be getting closer together.
Should you tell her to come in to hospital?
No
These are probably Braxton-Hicks contractions (false contractions)
They don’t lead to labour
They’re mild, irregular and don’t get more intense and frequent
A pregnant woman (week 42) rings you saying her waters have just broken but the liquid looks dark yellowy green.
Should you tell her to come in to hospital?
Yes.
The baby has passed meconium into the amniotic fluid, which means it could be distressed.
What happens in stage 2 of labour?
Pushing starts!
Mother is fully dilated
Baby navigates through pelvis
Head becomes visible
Baby does some ‘cardinal movements’
Before being born
What 3 things affect how well stage 2 of labour goes?
Describe them.
The 3 Ps
Power: how forceful the contractions are
Passenger: the fetus: size, position etc.
Passage: the route through the pelvis
What can you do if contractions aren’t strong enough?
Give oxytocin
One of the 3 P’s is passenger. What things about the fetus affect how easy stage 2 of labour is?
Size: of head
Attitude: is the baby flexed or deflexed? Better if the baby is flexed
Lie:
- longitudinal (ideal, baby’s spine is in line with mother’s
- transverse (perpendicular)
- oblique (at an angle)
Presentation:
- cephalic (head first, ideal)
- breech (bottom first)
- shoulder
Station:
- relationship between lowest point of presenting part and the ischial spines of mother’s pelvis
What is it called when the baby:
- presents head first
- presents shoulder first
- presents bottom first
- is lying with spine perpendicular to mother’s
- is lying with spine at an angle to mother’s
- is lying with spine aligned with mother’s?
- cephalic
- shoulder
- breech
- transverse
- oblique
- longitudinal
What is meant by vertex presentation?
When the baby is presenting cephalic (head first)
But with its head flexed, this is ideal
How can you tell what presentation the baby is?
Vaginal examination
Feel for the head, use the fontanel to guide you, should feel the posterior fontanel
