Physiology of labour, clinical aspects of bony pelvis Flashcards
What are the two stages of labour
1st- dilate the cervix
2nd- Push the baby out through the birth canal
What is the mechanism of cervical dilatation
Upper segment (smooth muscle) contracts. This stretches cervix over baby’s head
Lower segment (collagen) passively dilates and this closes over baby’s head
What is a problem during contraction
Each time there is a contraction, the blood flow stops to the placenta (reduced utero-placental blood flow). The baby develops hypoxia, acidosis and may die
Why would a baby develop hyperaemia during labour
There is reduced utero-placental blood flow during contraction. If labour is longer than normal or baby has very little glycogen stores in liver, then there’s a high chance of baby becoming acidotic and dying
What would you monitor in labour
Fetal heart rate- using ultrasound or stethoscope
Contractions
What would you do if there is fetal distress
Deliver baby by Caesarean section
How can you accelerate birth
Amniotomy
Oxytocin
What are the soft spots called on the baby’s head
Anterior and posterior fontanelle
How many sutures does the posterior fontanelle have running through it
Anterior?
Posterior- 3
anterior-4
What is the baby’s head like at first
Flexed
Oval- larger diameter front to back
Mechanism of labour
Flexion
Descent of baby in transversals position (sideways)
Internal rotation (shoulders enter inlet). This is when the baby’s face looks at your posterior wall
Delivery by extension
External rotation (shoulders enter outlet)
Anterior sdhoulder
Posterior shoulder
Rest of body delivers like a fish
Which are Mal-presentations in labour
Occipito-posterior position Occipito-lateral positions Brow presentation Face presentation Breech presentation Shoulder presentation
