pregnancy and birth

Question 1

What are some chemical changes that initiate labour

Answer 1

Increase in oestrogen (pro-labour hormone)
decrease in progesterone (pro-pregnancy hormone)
release of oxytocin (contracting hormone) by neurohypophysis.

Question 2

What are the different stages of labour

Answer 2

latent phase

1st, 2nd and 3rd phase

Question 3

What occurs in the latent phase of labour

Answer 3

changes that get mother ready for birth
Effacement of cervix
contractions (prostaglandins and oxytocin)
intensity varies

Question 4

what are the signs of active labour

Answer 4

Painful regular contractions
cervical effacement (can be checked digitally)
dilatation of the cervix of 4cms or more.

Question 5

how is the descent of the fetal head measured

Answer 5

Measured in relation to the ischial spines

Question 6

What point signifies the second stage of labour

Answer 6

full dilatation of the cervix to the delivery of the baby

Question 7

Describe the anterior fontanelle (bregma)

Answer 7

Diamond shop intersection of 4 sutures

closes at 18 months

Question 8

Describe the posterior fontanelle

Answer 8

Y shaped intersection of 3 sutures

closes at 6-8 weeks

Question 9

Outline the mechanism of birth

Answer 9

Head at pelvic brim occipital transverse (OT) position
flexion of neck (lifts up towards vagina)
head descends and engages
head reaches the pelvic floor-rotates to the occipital anterior position
head delivers by extension
head “restitutes” (comes in line with shoulders)
shoulders rotate into ant/pos diameter of the pelvis
anterior shoulder delivered by lateral flexion
posterior shoulder by upward lateral flexion.

Question 10

What is the large stage of labour, how much blood is lost and what must you inspect and why?

Answer 10

Delivery of the placenta
normal estimated blood loss 300-500 ml
inspection of placenta to ensure completion