normal_labour_flashcards

Question 1

What is the definition of normal labour?

Answer 1

The presence of strong, regular, painful contractions resulting in progressive cervical change.

Question 2

Into how many stages is normal labour divided?

Answer 2

Normal labour is divided into 3 stages.

Question 3

What marks the beginning and end of the 1st stage of labour?

Answer 3

The 1st stage begins with the onset of contractions and ends with full cervical dilatation (10cm) and effacement.

Question 4

What is the average duration of the 1st stage of labour in nulliparous women?

Answer 4

8 hours, expected to be <18 hours duration.

Question 5

What is the average duration of the 1st stage of labour in multiparous women?

Answer 5

5 hours, expected to be <12 hours duration.

Question 6

What are the subdivisions of the 1st stage of labour?

Answer 6

Latent phase and Active phase.

Question 7

What marks the beginning and end of the latent phase in the 1st stage of labour?

Answer 7

Begins with the onset of contractions and ends with 3-4cm cervical dilatation and full effacement.

Question 8

What marks the beginning and end of the active phase in the 1st stage of labour?

Answer 8

Begins with 3-4cm cervical dilatation and ends with full (10cm) cervical dilatation.

Question 9

What is considered normal progress in the active phase of the 1st stage of labour?

Answer 9

Cervical dilatation of at least 1cm every 2 hours.

Question 10

What is considered abnormal progress in the active phase of the 1st stage of labour?

Answer 10

Cervical dilatation of <2cm in 4 hours.

Question 11

What are the causes of prolonged 1st stage of labour?

Answer 11

Dysfunctional uterine activity, cephalopelvic disproportion, malpresentation.

Question 12

What marks the beginning and end of the 2nd stage of labour?

Answer 12

The 2nd stage begins with full cervical dilatation (10cm) and ends with the birth of the baby.

Question 13

What are the subdivisions of the 2nd stage of labour?

Answer 13

Passive phase and Active phase.

Question 14

What marks the beginning and end of the passive phase in the 2nd stage of labour?

Answer 14

Begins with full dilatation until head reaches pelvic floor and ends with the onset of involuntary expulsive contractions.

Question 15

What marks the beginning and end of the active phase in the 2nd stage of labour?

Answer 15

Begins with the onset of involuntary expulsive contractions and ends with the birth of the baby.

Question 16

What is considered prolonged 2nd stage of labour in nulliparous women?

Answer 16

Lasting >2 hours in a nulliparous woman (allow an extra hour if the woman has an epidural).

Question 17

What is considered prolonged 2nd stage of labour in multiparous women?

Answer 17

Lasting >1 hour in a multiparous woman (allow an extra hour if the woman has an epidural).

Question 18

What are the causes of prolonged 2nd stage of labour?

Answer 18

Secondary dysfunctional uterine activity, resistant perineum, persistent OP foetal head, android pelvis.

Question 19

What marks the beginning and end of the 3rd stage of labour?

Answer 19

The 3rd stage begins with the birth of the baby and ends with complete delivery of the placenta and membranes.

Question 20

What is the average duration of the 3rd stage of labour?

Answer 20

5-10 minutes.

Question 21

How can the management of the 3rd stage of labour be described?

Answer 21

Physiological or Active.

Question 22

What characterizes the physiological management of the 3rd stage of labour?

Answer 22

The placenta is delivered by maternal effort, associated with heavier bleeding, prolonged if lasting >60 mins.

Question 23

What characterizes the active management of the 3rd stage of labour?

Answer 23

Involves administering 10 iU oxytocin IM to the mother, controlled traction of umbilical cord, reduces incidence of PPH.

Question 24

What are the causes of prolonged 3rd stage of labour?

Answer 24

Uterine atony, placenta accreta.

Question 25

What are the steps in the mechanism of labour?

Answer 25

Descent, Engagement, Neck flexion, Internal rotation, Crowning, Extension of the presenting part, Restitution, External rotation, Lateral flexion, Delivery of the shoulders and foetal body.

Question 26

What is monitored during normal labour?

Answer 26

1-to-1 midwifery care, with obstetric and anaesthetic care available as required.

Question 27

What should be assessed during the initial assessment of labour?

Answer 27

Antenatal risk factors for foetal compromise including maternal and foetal factors.

Question 28

What are some maternal factors to assess during initial labour assessment?

Answer 28

Previous Caesarean birth, hypertensive disorder, PROM, vaginal blood loss, suspected chorioamnionitis or maternal sepsis, pre-existing diabetes.

Question 29

What are some foetal factors to assess during initial labour assessment?

Answer 29

Non-cephalic presentation, FGRSGA, advanced gestational age, anhydramnios/polyhydramnios, RFM in the last 24 hours.

Question 30

When should continuous CTG be considered during labour?

Answer 30

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.

Question 31

What are the routine measurements for the newborn?

Answer 31

Head circumference, birthweight, temperature, Apgar score at 1, 5, and 10 minutes, first dose of vitamin K, wrist label for identification.

Question 32

What immediate care should be given to the newborn?

Answer 32

Encourage skin-to-skin contact, dry and cover with a warm blanket, encourage initiation of breastfeeding within the first hour.