Stages of labour Flashcards
What is ‘normal’ labour? (2)
Normal labour starts between 37 and 42 weeks of pregnancy.
It is the cephalic delivery of a healthy infant.
How many stages of labour are there?
Three.
What are the two stages that occur within the first stage of labour? (2)
Latent first stage
Established first stage
What is the latent stage of labour? (3)
The latent stage of labour involves painful contractions. Cervical changes occur such as cervical effacement.
The cervix will dilate up to 4-5cm.
What is the established first stage of labour?
Regular painful contractions
Progressive cervical dilatation
This stage ends with full dilatation of the cervix at 10cm
Approximately how long does the established stage of labour last?
In primips, it usually does not usually exceed 12 hours
In multips, it does not usually exceed 10 hours
What causes cervical effacement, dilatation, and fetal descent?
Effective uterine contractions
Where do uterine contractions start?
At the fundus of the uterus
When can spontaneous rupture of membrane (SROM) occur?
At anytime
What is ARM?
Artificial rupture of membranes
What should be checked when membranes have ruptured?
The colour of the liquor (amniotic fluid)
What are the two stages that occur within the second stage of labour?
Passive second stage of labour
Active second stage of labour
What is the passive second stage of labour?
This is where full dilatation of the cervix occurs before or in the absence of involuntary expulsive contractions
What is the active second stage of labour?
The period of time between full cervical dilatation and birth of the baby
The woman has an involuntary urge to bear down due to expulsive uterine contractions
Approximately how long does the second stage of labour take?
In primips, within 3 hours
In multips, within 2 hours
Physiology of second stage of labour (4)
Contractions change in character
Ferguson’s reflex- surge of oxytocin
Membranes can rupture if not already
Soft tissue displacement
Name four signs that birth is imminent
Nausea and vomiting due to vagal stimulation
Uncontrollable urge to push due to contractions
Bulging of the perineum due to the presence of the fetal head
Feeling of burning due to the perineum being stretched by fetal head
What is the rhombus of Michaelis?
A kite-shaped area of the lower spine that moves backwards as the second stage of labour begins to increase the diameter of the pelvis
Name five factors that can impact on the length and success of the second stage of labour
Parity
Type of pelvis
Size of fetus
Fetal position
Regional analgesia
Uterine contraction activity
Maternal pushing efforts
Pain
Fear/anxiety
Fetal station at complete cervical dilatation
First stage of labour
What is the third stage of labour?
This is the stage from the birth of the baby until the delivery of the placenta and membranes
What happens during the third stage of labour?
The placenta separates, living ligatures contract and the placenta is expelled from the uterus
When is the third stage classed as prolonged with active management?
30 minutes
When is the third stage of labour classed as prolonged with physiological management?
60 minutes
