normal_labour_flashcards
What is the definition of normal labour?
The presence of strong, regular, painful contractions resulting in progressive cervical change.
Into how many stages is normal labour divided?
Normal labour is divided into 3 stages.
What marks the beginning and end of the 1st stage of labour?
The 1st stage begins with the onset of contractions and ends with full cervical dilatation (10cm) and effacement.
What is the average duration of the 1st stage of labour in nulliparous women?
8 hours, expected to be <18 hours duration.
What is the average duration of the 1st stage of labour in multiparous women?
5 hours, expected to be <12 hours duration.
What are the subdivisions of the 1st stage of labour?
Latent phase and Active phase.
What marks the beginning and end of the latent phase in the 1st stage of labour?
Begins with the onset of contractions and ends with 3-4cm cervical dilatation and full effacement.
What marks the beginning and end of the active phase in the 1st stage of labour?
Begins with 3-4cm cervical dilatation and ends with full (10cm) cervical dilatation.
What is considered normal progress in the active phase of the 1st stage of labour?
Cervical dilatation of at least 1cm every 2 hours.
What is considered abnormal progress in the active phase of the 1st stage of labour?
Cervical dilatation of <2cm in 4 hours.
What are the causes of prolonged 1st stage of labour?
Dysfunctional uterine activity, cephalopelvic disproportion, malpresentation.
What marks the beginning and end of the 2nd stage of labour?
The 2nd stage begins with full cervical dilatation (10cm) and ends with the birth of the baby.
What are the subdivisions of the 2nd stage of labour?
Passive phase and Active phase.
What marks the beginning and end of the passive phase in the 2nd stage of labour?
Begins with full dilatation until head reaches pelvic floor and ends with the onset of involuntary expulsive contractions.
What marks the beginning and end of the active phase in the 2nd stage of labour?
Begins with the onset of involuntary expulsive contractions and ends with the birth of the baby.
What is considered prolonged 2nd stage of labour in nulliparous women?
Lasting >2 hours in a nulliparous woman (allow an extra hour if the woman has an epidural).
What is considered prolonged 2nd stage of labour in multiparous women?
Lasting >1 hour in a multiparous woman (allow an extra hour if the woman has an epidural).
What are the causes of prolonged 2nd stage of labour?
Secondary dysfunctional uterine activity, resistant perineum, persistent OP foetal head, android pelvis.
What marks the beginning and end of the 3rd stage of labour?
The 3rd stage begins with the birth of the baby and ends with complete delivery of the placenta and membranes.
What is the average duration of the 3rd stage of labour?
5-10 minutes.
How can the management of the 3rd stage of labour be described?
Physiological or Active.
What characterizes the physiological management of the 3rd stage of labour?
The placenta is delivered by maternal effort, associated with heavier bleeding, prolonged if lasting >60 mins.
What characterizes the active management of the 3rd stage of labour?
Involves administering 10 iU oxytocin IM to the mother, controlled traction of umbilical cord, reduces incidence of PPH.
What are the causes of prolonged 3rd stage of labour?
Uterine atony, placenta accreta.
What are the steps in the mechanism of labour?
Descent, Engagement, Neck flexion, Internal rotation, Crowning, Extension of the presenting part, Restitution, External rotation, Lateral flexion, Delivery of the shoulders and foetal body.
What is monitored during normal labour?
1-to-1 midwifery care, with obstetric and anaesthetic care available as required.
What should be assessed during the initial assessment of labour?
Antenatal risk factors for foetal compromise including maternal and foetal factors.
What are some maternal factors to assess during initial labour assessment?
Previous Caesarean birth, hypertensive disorder, PROM, vaginal blood loss, suspected chorioamnionitis or maternal sepsis, pre-existing diabetes.
What are some foetal factors to assess during initial labour assessment?
Non-cephalic presentation, FGRSGA, advanced gestational age, anhydramnios/polyhydramnios, RFM in the last 24 hours.
When should continuous CTG be considered during labour?
When there are risk factors like contractions lasting longer than 2 minutes, presence of meconium, maternal pyrexia, suspected chorioamnionitis, abnormal pain, fresh vaginal bleeding, maternal pulse over 120 bpm, severe hypertension, etc.
What are the routine measurements for the newborn?
Head circumference, birthweight, temperature, Apgar score at 1, 5, and 10 minutes, first dose of vitamin K, wrist label for identification.
What immediate care should be given to the newborn?
Encourage skin-to-skin contact, dry and cover with a warm blanket, encourage initiation of breastfeeding within the first hour.
