St A - Parturition

Question 1

Define pre-term, term and post-term gestation periods

Answer 1

Pre-term: 24-37 weeks.
Term: 37-42 weeks.
Post-term: after 42 weeks

Question 2

How can you asses gestation age?

Answer 2

LMP - first day of menstrual period,
EDD (estimated date of delivery) - either via dates or scans (LMP + 9 months and + 7 days)
Estimating gestational age via ultrasound and via symphysial fundal height (SFH)

Question 3

What is the most common presentation of a fetus?

Answer 3

Cephalic presentation with occipital anterior (occipital of babys head on anterior side of mother)

Question 4

Describe how you diagnose labour?

Answer 4

History - Labour pains, show and sudden loss of fluid from vagina.
Abdominal Examination - Uterine contractions of frequency of 3 per 10mins and duration of 40-60s and severity.
Pelvic examination - cervical dilation, position and level of presenting part.

Question 5

What are the stages of labour?

Answer 5

0 - Quiescent (maintained by progesterone and relaxin).
Stage 1 - Initiation of parturition extending to complete cervical dilation. Increase in oxytocin receptor numbers due to oestrogen.
Stage 2 - Active labour from complete cervical dilation to delivery. Oxytocin released.
Stage 3 - From delivery to the expulsion of the placenta and final uterine contraction

Question 6

What is cervical ripening?

Answer 6

It refers to the softening of the cervix that typically begins prior to labour. It is necessary for cervical dilation and passage of the fetus

Question 7

Describe the positive feedback loop of oxytocin during labour

Answer 7

• Head of baby pushes against cervix,
• Nerve impulses from cervix transmitted to brain,
• Brain stimulates pituitary gland to secrete oxytocin.
• Oxytocin carried in blood stream to uterus,
• Oxytocin stimulates uterine contractions and pushes baby towards cervix.

Question 8

Describe the changes to the cervix in the first stage of labour?

Answer 8

There are two stages; the latent phase which is from 1-4cm dilation.
Active phase which is from 4-10dm dilation. This is when you will have rupture of membranes

Question 9

What are the pelvic stations?

Answer 9

Determines where the babies head is. At +3 the babies head will crown

Question 10

What is an episotomy?

Answer 10

Incision made in the perineum to increase the size of the vagina to prevent tearing to the anus

Question 11

What are signs of placental separation?

Answer 11

• Lengthening of cord,
• Gush of blood,
• Uterus becomes hard, mobile from side to side and height rises to umbilicus.

Question 12

What are some intrapartum methods of monitoring fetus

Answer 12

• Pinnard stethoscope,
• Doppler foetal heart rate,
• CardioTocoGram (CTG)