Physiology of labour & puerperium Flashcards
Parturition
The action of giving birth
What main change happens to cervix for delivery
It opens
First stage of labour
From onset of labour pains to fully dilated
Second stage of labour
Complete cervix dilation to delivery
Stage three of labour
Placental separation and expulsion
Uterine quiescence
Non contracting ‘quiet’ uterus
How does progesterone maintain uterine quiescence
Suppression of prostaglandin production
Prevention of oxytocin release
What does increase of oestrogen cause in the onset of labour
Prostaglandins to be produced
What happens to the myometrium in labour?
Retraction occurs in upper segment
Lower segment thins and causes effacement and dilation of cervix
At the peak of contraction are the muscles shorter or longer?
Shorter
What keeps the cervix closed
Collagen and elastin
What do prostaglandins do?
Reduce the amount of elastin and collagen in cervix to open it
Fire waters rupture due to what
Descent of the fetal head
Station
Descent of presenting part relative to the ischial spines
7 cardinal movements of labour
Descent of presenting part Flexion Internal rotation Extension Restitution External rotation Lateral flexion
Where does the pain of contractions occur along
Along the cutaneous nerve
Where does the pain of cervical dilation occur
Sacral plexus
Causes of pain
Myometrial hypoxia (oxygen deficiency)
Stretching of peritoneum (stomach membrane) over the fundus
Stretching of cervix
Puerperium
Period following childbirth
Body returns to pre Pregnant state
When does peurperium start
As soon as placenta is delivered
Involution
The movement of the uterus back to its pre pregnant state
Three types of lochia
Lochia rubra- blood, red
Lochia serosa- thinner, brow lochia alba-whitish
