Normal Labour & Management Flashcards
How many women died in childbirth every day in 2020?
800
What is the frequency of maternal deaths globally?
1 every 2 minutes.
What are the leading preventable causes of maternal death?
Severe bleeding, infection, pre-eclampsia.
How many stillbirths occur annually?
Nearly 1.9 million.
What percentage of stillbirths occur during labour?
Over 40%.
What are key preventable causes of stillbirth during labour?
Inadequate fetal heart rate monitoring, poor partogram use.
What signals the onset of labour?
Forces of release > forces of retention.
Name 5 factors that promote uterine retention during pregnancy.
Progesterone, Cervix integrity, Adrenaline, Relaxin, CRH.
What are the three P’s of labour?
Passage, Power, Passenger.
Define ‘tone’ in the context of uterine physiology.
Resting tone of uterus between contractions.
What is ‘fundal dominance’?
Uterine contractions stronger at the fundus.
How frequent are contractions in labour?
Typically 4 in 10 minutes.
What are Braxton Hicks contractions?
Irregular, non-labour uterine contractions.
What is the smallest diameter of the fetal skull?
Suboccipito-bregmatic (9.5 cm).
What is the largest diameter of the fetal skull?
Mento-vertical (13 cm).
What is the purpose of fontanelles in the fetal skull?
Allow skull overlap during birth (moulding).
Which is the most common fetal position at engagement?
Occipito-transverse (LOT or ROT).
What are the three stages of labour?
- First stage – Regular contractions to full dilatation.
- Second stage – Full dilatation to baby’s delivery.
- Third stage – Delivery of placenta and membranes.
What happens in the latent phase?
Irregular contractions, cervical effacement.
What defines first stage?
3-4 cm to 10 cm dilation with regular contractions.
What defines second stage?
Full dilation to baby delivery; includes passive and active phases.
What defines third stage?
Delivery of placenta; involves contraction and haemostasis.
What is the expected rate of cervical dilation?
~0.5 cm per hour.
What are the 7 cardinal movements of labour?
Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion.
What causes haemostasis in third stage?
Uterine muscle contraction around blood vessels.
What drug can help deliver the placenta?
Synthetic oxytocin.
What are key elements in managing normal labour?
Birth plan review
Maternal/fetal risk assessment
Observations (MEWS)
IA or CTG monitoring
Partogram use
VE every 4 hours
One-to-one support
Bladder emptying
Analgesia
What are the methods of fetal monitoring?
Intermittent auscultation
CTG (Cardiotocography)
Name some analgesia options in labour.
Simple oral analgesics
TENS
Entonox
Systemic opiates (Pethidine, Meptid, Morphine, Diamorphine)
Epidural
How can pain affect labour?
Pain may slow labour progress.
When does an obstetrician need to intervene?
Failure to progress (1st or 2nd stage)
Fetal compromise (e.g., hypoxia, sepsis)
Maternal compromise (e.g., haemorrhage, sepsis)
Delayed third stage
What are the four pelvic types?
Gynecoid, Android, Anthropoid, Platypelloid
