Physiology of labour and delivery

Question 1

what is gestation

Answer 1

Pregnancy is counted from the first day of the woman’s last period, not the date of conception which generally occurs two weeks later.

Question 2

gravity

Answer 2

how many times pregnant

Question 3

parity

Answer 3

how many times you have given brith

Question 4

nulligravida

Answer 4

never been pregnant so nerve blithered

Question 5

primigravida

Answer 5

woman carrying 1st fetus

Question 6

multigravida

Answer 6

pregnant woman who has been pregnant

Question 7

miscarriage when does it change to stillbirth

Answer 7

at 24 weeks not parity after that counts as a still birth

Question 8

what is Labour

Answer 8

the term which indicates the anatomical and physiological changes in the female reproductive tract that prepare the fetus and the placenta for delivery

Question 9

how many stages are there in labour

Answer 9

• 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

Question 10

stage 1 when the cervical opening occurs is split into to stages what are they

Answer 10

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.

Question 11

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

Answer 11

progesterone and oxytocin

Question 12

when does the second stage of labour begin and what is it

Answer 12

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.

Question 13

duration of second stage of labour with epidural and without

Answer 13

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

Question 14

most common shape of pelvic

Answer 14

Gynecoid

Question 15

most common pelvic shape of black people leading to occiput poster portion

Answer 15

anthropoid

Question 16

difference between complete breech, frank breech and footling

Answer 16

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.

Question 17

what fontanelles and sutures can be palpated in the baby

Answer 17

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

Question 18

the best postion for the head to be in when giving birth

Answer 18

head starts lateraly and moves occiput anteriorly as it moves through the pelvis and then the head flexes

Question 19

what is stage 3 of labour

how long does it last

Answer 19

delivery of the placenta

delivered by 15 minutes and 97% within 30 minutes of birth. - manually remove after this

major case of ppt

Question 20

difference between active and passive

Answer 20

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

Question 21

what is the 4th stage of labour

Answer 21

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

Question 22

4 causes of PPH

Answer 22

4ts 
tissue 
tone 
trauma 
thrombin