Stages of Labour

Question 1

What is First stage?

Answer 1

active and latent (from onset of contractions to 10cm dilated)

latent lasts >18hours (depending multi vs primi)

active at rate of 1.2cm or 1.5cm/hr (so avg 5 gours multi vs 8 hours primi)

Question 2

What is Latent stage + Mx

Answer 2

irregular contractions

Question 3

What is Active stage + Mx

Answer 3

4-10cm dilation w/ regular contractions ever 2-3mins lasting 45-60 seconds

Mx
admit
pain relief
midwife care
\+/- CTG
obs every 4 hours (w/ VE)
monitor HR every 30 mins ( with BP?)
plot labour on partograph

Question 4

What is Second stage

Answer 4

10cm dilation to expulsion

Mx
episiotomy
operative delivery
manouveres if obstructed/dystocia

Question 5

What is Second stage Arrest

Answer 5

> 3 hrs in second stage w/ epidural (primi)
2 hours second stage w/o epidural (primi)
2 hours second state w epidural (multi)`
1hr second stage w/0 epidural (multi)

Question 6

What is Third stage

Answer 6

placental deliver
mean time 6 mins
seek help/intervention if longer then 30mins

Question 7

What is Active Mx of 3rd stage

Answer 7

Bolus 10IU of oxytocin + IV oxytocin infusion according to guidelines

Question 8

What is Approach to Shoulder dystocia

Answer 8

Help
Episiotomy
Leg lift McRoberts 
Pressure: suprapubic pressure
Enter: rotational manouevers ( Rubins 2, woods-screw, reverse wood screw)
Remove posterior arm
Roll patient over ( onto legs
Refer: TRY everything at once if not -->zavenelli, symphisotomy, C/S

HELPERRR

Question 9

What is Fourth Stage

Answer 9

1 hr after delivery
high risk for PPH
monitor mothers vitals

Question 10

What is Cardinal movements of labor

Answer 10

Descent
Flexion
internal rotation
Extension
external rotation
Expulsion (ant shoulder --> posterior shoulder