Physiology of labour and delivery Flashcards
what is gestation
Pregnancy is counted from the first day of the woman’s last period, not the date of conception which generally occurs two weeks later.
gravity
how many times pregnant
parity
how many times you have given brith
nulligravida
never been pregnant so nerve blithered
primigravida
woman carrying 1st fetus
multigravida
pregnant woman who has been pregnant
miscarriage when does it change to stillbirth
at 24 weeks not parity after that counts as a still birth
what is Labour
the term which indicates the anatomical and physiological changes in the female reproductive tract that prepare the fetus and the placenta for delivery
how many stages are there in labour
- Stage 1: the cervical opening stage
- Stage 2: the pushing stage, ending in the birth of the baby
- Stage 3: the delivery of the placenta
- Stage 4: the first four hours after birth
stage 1 when the cervical opening occurs is split into to stages what are they
latent phase - effacement and dilation of OS to 4cm
active phase - dilation between 4-10cm, 2 hours in PG , 5cm for nulligraviad effacement is how thick the cervix is
dilation is of the cervical OS how many fingers between 0-10cm
The cervix is normally closed prior to the onset of labor. Cervical dilation describes how dilated the internal
cervical os is in centimeters, from 0 cm (closed) to 10 cm.
The external os may be several centimeters dilated while the internal os is closed or 1 cm dilated, especially in
multiparous patients. Ten centimeters means the cervix is fully dilated, and the first stage of labour is complete.
phase 0 of nulliparous labour progesterone is relax are dominant then come phase 1 oestrogen and prostoglandins take over then come phase 2 what is dominant
progesterone and oxytocin
when does the second stage of labour begin and what is it
begins when the woman’s cervix is completely dilated and completely effaced
During this stage the patient will push to deliver, and it ends with the delivery of the baby.
duration of second stage of labour with epidural and without
When patients have an epidural, its duration is approximately 70 minutes in nulliparous women vs 25 minutes in multiparous.
Without an epidural, these times are shorter - 35 and 15 minutes respectively.
additional factors can lengthen this stage including fatal size, occiput position, maternal body mass index
most common shape of pelvic
Gynecoid
most common pelvic shape of black people leading to occiput poster portion
anthropoid
difference between complete breech, frank breech and footling
Frank breech. The buttocks are in place to come out first during delivery. The legs are straight up in front of the body, with the feet near the head. This is the most common type of breech position.
Complete breech. The buttocks are down near the birth canal. The knees are bent, and the feet are near the buttocks.
Footling breech. One leg or both legs are stretched out below the buttocks. The leg or legs are in place to come out first during delivery.
what fontanelles and sutures can be palpated in the baby
The sagittal suture is the easiest
to palpate. Palpation of the distinctive lamdoid
sutures should identify the position of the fetal
occiput. The frontal suture can also be used to
determine the position of the front of the vertex
the best postion for the head to be in when giving birth
head starts lateraly and moves occiput anteriorly as it moves through the pelvis and then the head flexes
what is stage 3 of labour
how long does it last
delivery of the placenta
delivered by 15 minutes and 97% within 30 minutes of birth. - manually remove after this
major case of ppt
difference between active and passive
Active management involves early cord clamping, the use of uterotonics (such as oxytocin), and gentle traction on the umbilical cord.
Active management decreases the risk of postpartum haemorrhage by at least 60%, and lowers the risk of needing blood transfusions
passive is on its own
what is the 4th stage of labour
The first four hours immediately following placental delivery are critical, and represent the fourth stage of labour.
Maternal blood pressure and pulse should be recorded immediately after delivery and every 15 minutes for the first four hours.
Normally, after the delivery of the placenta, the uterus will become firm due to sustained contraction, so the
woman might feel strong contractions after the birth. Reassure her that these contractions are healthy, and help to stop the bleeding
4 causes of PPH
4ts tissue tone trauma thrombin
