obs & gynae

Question 1

define labour

Answer 1

Definition = the presence of strong, regular, painful contractions resulting in progressive cervical change

Question 2

• Causes of prolonged 1st stage of labour:

Answer 2

o Dysfunctional uterine activity ie weak or infrequent contractions
o Cephalopelvic disproportion ie disproportion between foetal head and maternal pelvic size
o Malpresentation

Question 3

• Causes of prolonged 2nd stage of labour:

Answer 3

o Secondary dysfunctional uterine activity
o Resistant perineum (particularly if nulliparous)
o Persistent OP foetal head
o Android pelvis

Question 4

• Management of the 3rd stage can be described as:

Answer 4

o Physiological

 Where the placenta is delivered by maternal effort
 Associated with heavier bleeding
 Prolonged = lasting >60mins

o Active

 Recommended to all women
 Involves administering 10 iU oxytocin IM to the mother (with the birth of the anterior shoulder or immediately after delivery)
 Controlled traction of umbilical cord after signs of separation of the placenta
 Reduces incidence of PPH (from 15% → 5%)
 Prolonged = lasting >30mins

Question 5

• Causes of prolonged 3rd stage of labour:

Answer 5

o Uterine atony
o Placenta accreta

Question 6

outline Immediate Care of the Newborn

Answer 6

• The baby will usually take its first breath within seconds
• After clamping and cutting the umbilical cord, the baby should have an Apgar score calculated at 1 minute of age and then repeated again at 5 minutes and 10 minutes.

o A score of 0-3 is very low score, between 4-6 is moderate low and between 7 - 10 means the baby is in a good state.

• Encourage skin-to-skin contact between mother and baby as soon as possible after birth
• Dry and cover the baby with a warm blanket or towel, maintaining this contact
• Encourage initiation of breastfeeding within the first 1 hour
• Routine measurements of newborn head circumference, birthweight and temperature should be measured soon after this hour
• Administer the first dose of vitamin K to the baby in the delivery room
• Attach a wrist label to the baby for identification

Question 7

what is considered preterm labour

Answer 7

onset of labour before 37 weeks gestation