Normal Labour & The Partograph Flashcards
What is Labour?
Labour is the onset of painful regular contractions with progressive cervical effacement and dilatation that terminates with delivery of fetus and placenta
Labor management involves what interplay?
Ethical, medical and social
How is labor initiated?
Mechanism of labour initiation is unknown
Factors that may be responsible for initiating labour can be either?
Fetal or Maternal
Maternal factors that may initiate labour?
- Oxytocin release/receptors
- Prostaglandins release/receptors
- Retraction of uterine muscles
What fetal factor can initiate labour?
Oxytocin release from posterior pituitary gland
The outer bony parts of the pelvic inlet is the?
Pelvic brim
The pelvic inlet separates?
The greater(false) pelvis from the lesser(true) pelvis
The pelvic inlet separates?
The greater(false) pelvis from the lesser(true) pelvis
The boundaries of the pelvic brim are?
Anterior: Pubic symphysis
Posterior: Sacral Promontory
Lateral: Ala of the ilium, upper margins of the pubic bone, iliopectineal line
Boundaries of pelvic mid cavity?
Anterior: Middle of the pubic symphysis
Posterior: Junction between 2nd and 3rd bones of sacrum
Lateral: Obturator fascia, inner parts of ischial bones and spine
Boundaries of Pelvic Outlet
Anterior: Inferior part of pubic symphysis
Posterior: Last piece of Sacrum
Lateral: Ischial tuberosity, inferior pubic ramus, sacrotuberous ligament
Antero-posterior diameter of the pelvic brim of the female pelvis is?
11cm
Transverse diameter of the pelvic brim is?
13.5cm
Angle of inclination of pelvic brim to the horizontal in an erect position is?
60°
The angle of inclination to the horizontal in Afro Caribbean women can be up to?
90°
The fetal skull has three major parts. What are they?
Face, Base and Vault
The bones of the cranial vault in fetus are?
Majorly the parietal bone, then parts of the frontal, temporal, and occipital bones.
How many sutures are present on the fetal skull?
Coronal, Sagittal, Lambdoid and Frontal
What are the fontanelles on a fetal skull?
Anterior and Posterior fontanelles
What are the diameters of the fetal skull?
Sub occipito bregmatic: 9.5cm (Flexed vertex presentation)
Sub occipito frontal: 10cm (Partially flexed vertex presentation)
Occipito-frontal: 11.5cm (Deflexed presentation)
Mento-vertical : 13cm (Brow)
Sub mento bregmatic : 9.5cm (face)
There are how many stages of labour?
Three stages
The first stage of labour can be up to what cm of cervical dilatation?
10cm
The 1st stage of labour is divided into?
Latent phase and Active phase
Characteristics of latent phase (1st stage of labour)
Cervical dilatation is < 4cm
Woman has at least 1 contraction every 10 minutes
In the active phase of 1st stage of labor, cervical dilatation is?
At least 4cm
What happens in the second stage of labour?
Full cervical dilatation (10cm) to delivery of the fetus
The third stage of labor comprises of?
The delivery of the fetus and the placenta
Changes in attitude and position that a fetus undergoes as it passes through the birth canal is?
Mechanism of labor
The Mechanism Of Labor is?
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- Restitution
- External Rotation
Duration of the latent phase of labor?
8 hours
Latent phase of labour that last ≥ 8 hours is?
Prolonged latent phase
Latent phase of labor lasting more than 24 hours is regarded as?
False labour
Duration of Active laborr
12 hours
List the eight steps for the management of normal labor
- Provide care and emotional support
- Observe pregnancy and be ready for timely intervention if it becomes abnormal.
- Monitor fetal wellbeing
- Administer adequate and appropriate pain relief consistent with the woman’s wishes.
- Adequate hydration to prevent ketosis.
- Review obstetric history
- Examination (General Physical, Abd, and Vaginal examinations)
- Fetal assessment in labor
What is a partograph?
A partograph is a graphic record of labor that allows the rate of cervical dilatation against the expected norm to be instantly visualized
A partograph was thought to reduce four things. What are they?
- Prolonged labour
- Incidence of Caesarean section
- Augmentation with oxytocin
- Need for analgesia in labour
In the BioData part of the partograph, what are the recordings?
- Name
- Gravidity
- Hospital Number
- Date & time of admission
- Time of membrane rupture
Other things displayed on the partograph besides cervical dilatation rate and BioData are?
- Frequency and strength of contractions
- Descent of fetal head.
- Quantity and color of amniotic fluid
- Moulding
- Temperature
- Proteins
- Fetal heart rate
- Blood pressure
- Pulse rate
- Fetal heart rate should be recorded every ______
- Pulse rate should be recorded every ____
- On the partograph, pulse rate is marked with a _____
- 30 minutes
- 30 minutes
- Dot
Blood pressure should be recorded every ______ and is marked by ___
- Four hours
- C/O
Temperature on the partograph should be recorded every ______
2 hours
When should proteins be recorded?
After every passage of urine
Amniotic fluid inspection and cervical dilatation should be done during?
Every vaginal examination
The meaning of each of these letters in inspection of amniotic fluid is?
M
B
I
R
C
M - Meconium stained fluid
B - Blood-stained fluid
I - Membrane intact
R - Membrane ruptured
C - membrane ruptured, clear fluid
Cervical dilatation is marked as ___ on the partograph
X
