Pregnancy, Labour and Puerpium Flashcards
what does progesterone do in labour?
keeps the uterus settled
what does oestrogen do in labour?
makes the uterus contract by increasing prostaglandins
what hormone initiates and sustains contractions?
oxytoxin
what are the two parts of the first stage of labour?
latent
active
what happens to the cervix in latent stage of labour?
softens
shortens
dilates to 4cm
what happens to the cervix in active stage of labour?
4cm to full dilation
what are the features of the latent stage of labour?
mild irregular uterine contractions
how long does the latent stage of labour usually last?
few days
what are features of the active stage of labour?
contractions are 3/4 times every 10 mins
what happens to the fetus in active labour?
descent
flexion
what happens to the cervix in the second stage of labour/
dilates to 10cm
what happens in the second stage of labour?
delivery of baby
in nulliparous women, when is delivery prolonged?
> 3hrs with anaesthetic
>2hrs without
in multiparous women, when is delivery prolonged?
> 2hrs with anaesthetic
>1hr without
what happens in third stage of labour?
delivery to expulsion of placenta and fetal membranes
how long does third stage labour usually last?
10mins
what are options of active management of third stage labour?
syntometerine
oxytocin
controlled cord traction
cord clamping and cutting
what is puerpium? how long does it last?
repair and recovery to a non pregnant state
6 wks
when can braxton hicks happen?
2nd/3rd trimester
features of braxton hicks?
irregular
resolve on moving
relatively painless
features of contractions?
evenly spaced
time between gets shorter
wave of pain
hard abdo
where does fertilisation usually occur?
ampulla of fallopian tube
what are the two sides of the blastocyst called? which side is mums side?
cytotrophoblast
synctiotrophoblast (mums)
when have trophoblast cells of the blastocyst burrowed by?
day 12
what side of the blastocyst forms the placenta?
synctiotrophoblast (mums)
when is the placenta functional by?
week 5
how does the placenta gain its blood supply?
synctiotrophoblast invaded endometrium
lacunae fill with maternal blood
fuse to form blood supply
what produces HCG? when does this start?
trophoblast cells
day 8
before the placenta forms, what provides nutrition to embryo?
decidual cells (of the endometrium)
how does O2/CO2 get to and from baby?
O2 - umbilical vein (mum to baby)
CO2 - endometrial vein (baby to mum)
what allows fetus to gain more O2?
fetal Hb can carry more O2
higher Hb in fetus
bohr effect (more O2 in decreased pO2)
what does HCG do?
stop degeneration of CL
when is HPL produced?
week 5
what does HPL do?
growth hormone
decreases mums insulin sensitivity
helps breasts develop
what does progesterone do to the blood?
decreases CO2, increased O2
what effect does decreased CO2 have on mum?
increased RR
decreased pCO2
increased TV
what CVS changes happen during pregnancy?
increased CO
increased HR
BP can drop in 2nd trim (returns to normal by 3rd)
in the blood, what changes can occur during pregnancy?
decreased CO2
decreased Hb
increased PV
what renal changes can occur?
increased GFR
increased renal plasma flow
why is Hb low in pregnancy?
due to dilution
erythropoeisis is infact increased
what happens to hepatic blood flow during pregnancy?
doesn’t change
ALP raised
albumin decreased
how does blastocyst embed?
synctiotrophoblast sends out finger like projections to embed into the endometrium
when has blastocyst formed by? when does it implant?
day 4
day 5
what hormones does the placenta secrete?
oestrogen
progesterone
HCG
HPL
