Second Stage of Labour

Question 1

How often should you do FHR asculation and what is the normal FHR?

Answer 1

Every 5 minutes for a full minute after a contraction, normal rate between 110 - 160bpm.

Question 2

How often should maternal pulse be checked?

Answer 2

Every 15 minutes to differentiate between FHR

Question 3

How often should the frequency of contractions be documented?

Answer 3

Half hourly

Question 4

How often should BP, temperature and VE’s be checked?

Answer 4

Hourly BP
4 hourly temperature
Hourly VE’s offered

Question 5

How long does NICE recommend for the 2nd stage? (Primip)

Answer 5

Should take place within 3 hours of the start of the active 2nd stage, suspect delay in progress if descent of presenting part inadequate after 1 hour of active stage

Question 6

How long does NICE recommend for the 2nd stage? (Multip)

Answer 6

Should take place within 2 hours of the start of the active stage, suspect delay if descent of the presenting part inadequate after 30 minutes

Question 7

How can normal physiological processes be supported?

Answer 7

“Hands on” or “hands poised”
Observe for advancing head
Gentle counter pressure with fingers to keep head flexed and avoid quick expulsion
Observe for restitution and external rotation
SSC
Delayed cord clamping

Question 8

How can perineal trauma be reduced?

Answer 8

Perineal guarding
No routine episiotomy
“Hands on” or “hands poised”
Use of warm compress on the perineum