Normal vaginal birth + pregnancy

Question 1

Describe the onset of labour?

Answer 1

The point at which uterine contractions become regular and cervical effacement and dilation becomes progressive.

Question 2

Describe the overview of labour (6)

Answer 2

1. onset of uterine contractions, which increase in frequency, duration, and strength over time.
2. Cx effacement and dilatation.
3. ROM with leakage of amniotic fluid.
4. Descent of the presenting part through the birth canal.
5. birth of baby.
6. delivery of placenta and membranes.

Question 3

Describe the sequence for the passage through the pelvis for a normal vertex delivery? (7)

Answer 3

1. Engagement and descent:
   - > the head enters the pelvis in the OT position with flexion increasing as it descends.
2. IR to OA:
   - > occurs at the level of the ischial spines due to the forward and downward sloping of the levator ani muscles.
3. Crowning
   - > the head extends, distending the perineum until it is delivered.
4. Restitution: the head rotates so that the occiput is in line with the fetal spine.
5. ER:
   - > the shoulders rotate when they reach the levator muscles until the biacromial diamter is AP (the head ER by the same amount.
6. Delivery of the ant shoulder
   - > occurs by lateral flx of the turnk posteriorly.
7. Delivery of the posterior shoulder:
   - > occurs by lateral flexion of the trunk anteriorly and the rest of the body follows.