Physiology of labour

Question 1

First stage of labour

Answer 1

Regular contractions
End = cervix dilated at 10cm

Question 2

Second stage of labour

Answer 2

Start = Cervix dilated at 10cm, urge to push
Pushing
Baby fully out = end

Question 3

Third stage of labour

Answer 3

placental delivery

Question 4

Before regular contractions in the first stage of labour, what happens?

Answer 4

The LATENT phase - irregular contractions, dilation up to 4 cm

Question 5

How long is the third stage?

Answer 5

Can last up to 30 minutes, can be active or passive

Question 6

What determines the progress of labour? (3 Ps)

Answer 6

Power of contractions
Passage - dimensions of the pelvis
Passenger - diameter of the foetal head

Question 7

What counts as normal progression of the first stage?

Answer 7

Dilation of cervix by 1cm every hour

Question 8

How often do you check up on the mum during the first stage of labour?

Answer 8

Every 4 hours until they’ve dilated more

Question 9

Summarise the management of the first stage of labour

Answer 9

Provide 1-1 midwifery care
Perform vaginal examinations every 4 hours or as clinically indicated
Ensure adequate analgesia, food, hydration

Give antacids,

Question 10

Why ensure a light diet during pregnancy?

Answer 10

To avoid ketosis - this can impair uterine contractions

Question 11

If there is a delay in dilation or regular contractions in the first stage of labour, how do you manage this?

Answer 11

Check if the membrane is intact.

if membrane is intact: ARM then review in 2 hours
If membranes have ruptured, give oxytocin and increase every 15-20 minutes until there are regular contractions. Once there are regular contractions, review in 4 hours.