stages of labour Flashcards
cerivical dilatation..latent phase?
3-4cm dilation
active phase - 4-10cm dilation
FULL DILATAION
in nulliparous women delivery considered prolonged if it lasts longer than?
3 hours
how long does expulsion of the placenta usually take?
10 mins, but can be longer
active management - delivery of placenta - why
lower risk of post part haemorrhage
admin of oxytocin, ergometrine, cord clamping and cutting, injection of oxytocin directly in to chord
.
why do you get cervical softening?
increase in hyaluronic acid gives increase in molecules among collagen fibres. decreased bridging causes decrease in firmness of cervix. decrease in tensile strength, increase in cervical decorin
painless contractions, resolve with ambulation/change in activity/position?
braxton hicks
what are these?
tightening of uterine muscles, thought to aid the body to prepare for birth
when can they start from?
6 weeks
abdomen hard, come and go, 5 minutes apart, evenly spaced reduction in time between contractions. what does the body release during these contractions?
oxytocin
greatly painful, don’t resolve with change of position
.
what collagen types are present in the cervix?
1-4
what acts as pacemaker in contractions?
tubal ostia
front suture, in line with sagittal?
metropic
back (horizontal)
lamboid
in multiparous women - delivery prolonged if it exceeds ____hours?
2
what is crowning?
appearance of a large section of metal head at the introitus
largest diameter of metal head is encircled by the metal ring
burning/stinging feeling for the mother
name of the procedure carried out t prevent tearing of anus>
episiotomy
5 parameters for assessing the cervix?
EDLFP - effacement, dilataion, level of presenting part, firms, position
normal blood loss at pregnancy?
less than 500ml
if greater?
abnormal
more significance if above?
1500ml
any blood loss prior to delivery is abnormal and needs to be referred to consultant unit
.
plane of separation in placenta?
spongy layer of decidua basalis
signs of placental separation?
uterus contracts, hardens and rises, umbilical cord lengthens permanently, gush of blood
what is considered a normal time for placental expuslion
usually 5-10 mins - but up to 30 mins is normal
what is puerperium?
period of repair and recovery. return of tissues to non pregnant state - 6 weeks
collostrum - rich in antibodies, but no ?
fat
decrease in oestrogen and progesterone. lactation is initiated by placental expulsion
if placenta not out by 1 hour, prepare for removal under GA
what inhalation agent acts as anaesthetic?
entonox
does epidural impair uterine activity?
no, but it might slow stage 2
complications?
hypotension, dural puncture, headache, back pain, atonic bladder
failure to progress at stage 1 - dilation?
if dilation less than 2 cm in 4 hours
