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Reproductive System > Parturition And Labour > Flashcards

Parturition And Labour Flashcards

1
Q

Define parturition

A

The scientific term used to describe the transition from the pregnant state to the non-pregnant state at the end of gestation

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2
Q

Define labour

A

The non-scientific term used to describe parturition when both the cervix and uterus have been remodelled

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3
Q

What is a spontaneous abortion?

A

If the products of conception are expelled before 24 weeks

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4
Q

Define pre term

A

< 36 weeks

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5
Q

Define term in weeks

A

37 - 42 weeks

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6
Q

Define post term

A

> 42 weeks

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7
Q

What is the biggest cause of mortality mortality in the UK?

A

Going past 42 + 6

Carries lots of risks

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8
Q

Briefly describe what occurs in the first stage of labour

A

Creation of the birth canal

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9
Q

Briefly describe what happens in the second stage of labour

A

Expulsion of foetus

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10
Q

Briefly describe what happens in the third stage of labour

A

Expulsion of placenta

Contraction of uterus

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11
Q

When does the uterus become palpable?

A

12 weeks

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12
Q

Where is the fundus palpable at 20 weeks?

A

Umbilicus

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13
Q

Where is the fundus palpable at 36 weeks?

A

Xiphisternum

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14
Q

When does the foetus orientate itself correctly for birth?

A

24 weeks

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15
Q

Why do we weight the placenta?

A

Should be around the same weight as the foetus

Too large, too small or calcification - indications that the baby may need extra care

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16
Q

What is the ‘lie’ of the foetus?

A

Relationship to the long axis of the uterus
Normally longitudinal
Foetal spine antiparallel to mothers

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17
Q

What is the ‘presentation’ of the foetus?

A

Which part is adjacent to the pelvic inlet

Normally the head (cephalic)

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18
Q

What is the ‘vertex’ of the foetus?

A

Relationship of foetus along its axis
Head 45 degrees to own spinal cord
Orientation of the presenting part

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19
Q

What is the most common description of a presenting foetus?

A

Longitudinal lie
Cephalic presentation
Vertex to pelvic inlet at minimum diameter

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20
Q

What is the average diameter of the foetal head?

A

9.5 cm

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21
Q

What proteins usually expand the soft tissues of the pelvis?

A

Metalloproteases (type of collagenase)

22
Q

What is effacement?

A

The internal and external Os come together (of the cervix)

23
Q

What is the medical term for softening of the cervix?

A

Cervical ripening

24
Q

Which prostaglandins are most responsible for cervical softening?

A

PGE2

PGF2 alpha

25
Q

Why does hyaluronic acid build up in cervical softening?

A

Hydrophilic

Water moves into tissues causing expansion

26
Q

What are Braxton Hicks?

A

Amplitude of contractions increases
Less frequent than ‘real contractions’
Uterus getting ready for labour

27
Q

Define clinical labour

A

3 contractions within 10 minutes, each lasting at least 1 minute

28
Q

Which hormonal ratio changes PG synthesis?

A

Oestrogen:progesterone
Increased oestrogen = increase PGs
Decreased progesterone = increase PGs

29
Q

Where is oxytocin secreted?

A

Posterior pituitary

30
Q

What do we call the reflex that increases oxytocin release?

A

Ferguson reflex

31
Q

What are the effects of increased prostaglandins?

A

Cervix ripens
Contractions more forceful
Brachystasis

32
Q

What is brachystasis?

A

Uterus contracts more than relaxes
Fibres shorten in body of uterus
Drives presenting part into cervix

33
Q

When does the first stage of labour end?

A

When the cervix is dilated to 10 cm

34
Q

Second stage of labour is usually how long?

A

Up to an hour

35
Q

What do we call it if the foot presents first?

A

Footling breech

36
Q

How long does 3rd stage of labour usually last?

A

Within 10 minutes

37
Q

What are some stimuli that cause baby to take its first breath?

A

Trauma
Cold
Light
Noise

38
Q

What are the major goals of uterine contractions?

A

Dilate cervix

Push foetus through birth canal

39
Q

What are the 3 Ps of labour?

A

Powers
Passenger
Passage

40
Q

How does the foetus contribute to labour?

A

Glucocorticoids released to inhibit progesterone

Foetal oxytocin produced

41
Q

How do we induce labour?

A

Give prostaglandins directly into vagina

42
Q

What does the ‘attitude’ of the foetus refer to?

A

Flexion or extension of the foetal head

43
Q

What is the difference between frank and full breech?

A 
Frank = knees extended
Full = knees flexed
44
Q

Why is cord prolapse a problem?

A

Cools down as comes out of cervix
Arteries spasm
Stops oxygen to the baby therefore indication for C section

45
Q

What is the latent phase of labour?

A

1st part of 1st stage
Onset of labour with slow cervical dilation up to 4cm
Variable duration

46
Q

What is the active phase of labour?

A

2nd part of 1st stage
Faster rate of cervical change
1 - 1.2 cm per hour
Regular uterine contractions

47
Q

What are some of the biggest causes of maternal mortality?

A

Pre-eclampsia/eclampsia
Post partum haemorrhage
Obstructed labour
Unsafe abortion

48
Q

What incision do we use for C section?

A

Pfannenstiel

49
Q

When would we take a mum to labour AFTER the delivery of the baby?

A

If placenta hasn’t delivered within an hour after brith
3rd stage of labour not complete
Risk of infections and heavy bleeding

50
Q

What is the normal blood flow to the placenta?

A

500 - 800 ml/min

51
Q

How does the body control bleeding post delivery?

A

Powerful contractions/retraction of uterus
Pressure exerted on placental site by walls of uterus
Blood clotting mechanism - pregnancy is pro-thrombotic

Reproductive System (17 decks)

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