Progress in labour Flashcards
How do you diagnose delay in 1st stage of labour in a primigravida?
Cervical dilation <2cm in 4 hours
How do you diagnose delay in 1st stage of labour in a multigravida?
Cervical dilatation <2cm in 4 hrs or a slowing down of progress
What are three things to consider when thinking about progress of labour?
Three Ps:
power - uterine contractions
passenger - foetal position and size
passage - parity and maternal pelvis
What are the three Ps?
Things that effect progress of labour
power - uterine contractions
passenger - foetal position and size
passage - parity and maternal pelvis
What are the three Ps used for?
Thinking about things that impact progress of labour (therefore something that may be delaying it or can be done to improve progress)
How would you manage a woman who has had slow progress in the 1st stage of labour?
ARM
Syntocinon infusion
C-section
What is a partogram?
A pictorial record of labour
What variables are included on a partogram?
cervical dilatation and descent of the head
frequency of contractions
fetal heart rate
Liquor colour
maternal observations
What instruments are available to assist vaginal delivery?
Vacuum extraction
Traction forceps
Rotational forceps
What maternal factors might make you consider using assisted vaginal delivery?
Slow progress in 2nd stage
Maternal exhaustion
To avoid raising intracranial pressure
To avoid raising blood pressure
What maternal factors might make you consider using assisted vaginal delivery?
Slow progress in 2nd stage
Maternal exhaustion
To avoid raising intracranial pressure
To avoid raising blood pressure
What foetal factors might make you consider using assisted vaginal delivery?
Presumed fetal compromise
How would you prepare someone for delivery?
Consent Analgesia Adequate contractions Empty bladder Accurate knowledge of where the baby is positioned Ruptured membranes
What are complications of assisted vaginal delivery?
Failure Increased blood loss Postpartum pain Perineal trauma Weakness of pelvic floor Psychological
What are some maternal complications of assisted vaginal delivery?
Failure Increased blood loss Postpartum pain Perineal trauma Weakness of pelvic floor Psychological
