Stages of Labour Flashcards
How many stages of labour are there?
3
How is the first stage divided?
Into latent and active phase
Describe the latent phase of the first stage of labour.
This is the time between the onset of regular contractions of the uterus and the dilatation and effacement of the cervix up to 4cm. This stage can last some time, particularly in primiparous women.
Describe the active phase of the 1st stage of labour
The regular contraction of the uterus and the dilatation and effacement of the cervix from 4cm up to 10cm.
What should be checked during the 1st stage of labour, how often and why?
- Vaginal examination: every 4 hours to assess dilatation and position of the head.
- Urine dipstick: every 4 hours to monitor mum and make sure there are no signs of pre-eclampsia.
- Maternal temperature and BP: every 30 minutes to assess for any signs of PET or sepsis.
- Contractions: every 15 minutes, check strength and length
- Foetal HR: every 15 minutes, try before the contraction to make sure that the baby is stable
What are the 2 phases of the 2nd stage of labour?
Passive and active
Describe the passive phase of the 2nd stage.
During the passive phase, the cervix is fully dilated at 10cm and effaced. This is when the uterus is contracting only and mum is NOT pushing to help expel the baby.
Describe the active phase of the 2nd stage
The active phase is when the uterus is regularly contracting and mum is using her abdominal muscles to push baby out of the birthing canal. This phase ends when the baby is born.
Describe the 2nd stage of labour.
The second stage of labour follows from the full dilatation and effacement of the cervix (10cm) up until the birth of the foetus.
What is the 3rd stage of labour?
This is the final stage of labour and is the period of time from when the baby is born to when the placenta and membranes are delivered.
How long is the 3rd stage of labour usually?
30 minutes.
What is given as an injection to the mother at the end of the 2nd stage to speed up the 3rd stage (active 3rd stage management)?
Syntocinon or ergometrine
What are the features of the placenta that should be assessed after it’s delivery?
Size, shape, consistency, colour and completeness
How big should the placental normally be?
Around 22cm, 2-2.5cm thickness and 1lb in weight.
What features should there be in the transverse cut of the umbilical cord?
- Wharton’s Jelly
- 2 umbilical arteries
- 1 umbilical vein
What are ‘Braxton Hicks’?
‘Practice contractions’ that are common after 36/40. These are NON-PAINFUL.
What is a mucus plug?
A mucus block at the external os to prevent bacteria from reaching the foetus.
What is ROM?
Rupture of membranes
What is SROM?
Spontaneous rupture of membranes
What is Prelabour ROM?
ROM before labour begins
What is P-PROM?
Preterm prelabour ROM i.e. before 37/40
What is PROM?
Prolonged ROM (>18 hours before delivery)
When is a baby classed as premature?
If born before 37/40
How is a baby classed if they are born <28/40?
Extremely preterm
How is a baby classed if they are born 28-32/40?
Very preterm
How is a baby classed if they are born 32-37/40?
Moderate to late preterm
When does a baby need to be born to be classed as extremely preterm?
<27/40
When does a baby need to be born to be classed as very premature?
28-32/40
When does a baby need to be born to be classed as moderate to late preterm?
32-37/40
How long should it take for cervical dilatation?
Women should progress at 0.5-1cm per hour
How do we measure cervical effacement?
Placing a finger inside the vagina and into the cervix, to check its length.
How long should the second stage of labour last?
2-3 hours
How long should the active phase of 1st stage of labour last?
6-12 hours
