WEEK 2 Flashcards
What is labor?
This is the presence of regular painful uterine contractions of increasing frequency and intensity that cause progressive cervical effacement and dilation, accompanied by pelvic descent and subsequent expulsion of the products of conception.
What is your own understanding about a “show”?
This is a blood stained mucus released from the cervix and expelled through the vagina during the onset of labour.
What is considered as normal pregnancy?
*Full term pregnancy ( 37-42/54 weeks)
*Singleton pregnancy ( birth of only one child during a single pregnancy with a gestation period of 20/54 weeks or more)
*Vertical presentation of the fetus
*The labour should be spontaneous
* Live fetus
Briefly define the first stage of labour?
The 1st stage of labour begins with the onset of uterine contractions of sufficient frequency and intensity which subsequently lead to cervical effacement and dilation. The 1st stage of labour ends when cervix is fully dilated at 10cm.
State the average and range of duration of the 1st stage of labour in primigravida and multigravida.
PRIMIGRAVIDA
Average= 12/24hrs
Range= 6-18/24hrs #MULTIGRAVIDA
Average=7/24hrs
Range= 2-10/24hrs
In terms of labour progression and cervical changes occurring during labour, what difference will see in nulliparous woman and a woman of parity 2 or more.
With a nulliparous woman, duration of labour( 6-18hrs), and cervical effacement and dilation will occur within longer period
With a woman of parity 2 or more, duration of labour( 2-10hrs), and cervical effacement and dilation will occur within a short period.
*Uterine contractions are less frequent
*They is slow effacement and dilation of the cervix
* Slow progression from onset of labour pains to 5cm cervical dilation.
Latent phase of the first stage of labour
What are the characteristics of the active phase in the 1st stage of labour.
They is rapid progression from 6cm to full dilation of the cervix (10cm)
NOTE! Average progression cervical dilation:
1.2cm/hr in PG
1.5cm/hr in MG
Starts from a fully dilated cervix and ends with the delivery of the fetus.
second stage of labour
How do we assess progression during the second labour.
By assessing the descent of the presenting part.
Drop of fetal head/fetus into the birth canal
Lightening
What is used as a reference to assign numbers in the fetal station.
Ischial spines
What enables extension of the head to occur during labour.
Anatomical position of vulvar; vulvar is directed upward and forward
The fetal heart-rate intermittent observations are done immediately after uterine contraction. Preferably which position is best to conduct such observation
Left lateral position
What is the normal heart beat range for a fetus.
110-160 bpm
What is Ante-natal care
This involves a coordinated approach to medical care and psychosocial support that optimally begins before conception and extends throughout the antepartum period.
“Ensuring that all women have access to the information and care they need to go safely through pregnancy, childbirth and puerperium”, is known as
Safe motherhood
List the essential health sector interventions for safe motherhood
*Family planning
*Postabortion
*Antenatal care
*Clean/safe delivery
*Postpartum care
*Essential obstetric care
How many scheduled visits are recommended during antepartum?
8 visits
When should intermittent preventative treatment of malaria be initiated
13 weeks of pregnancy
Defined as the time from the delivery of the placenta throughout until 6weeks post-partum.
Puerperium/ postnatal period
List 3 objectives of postnatal care
*Prevent or detect and manage complications
*Promote and maintain well-being of the mother and child
*Contraception and resumption of sexual activity
Explain what is meant by maternal death.
Death of a woman while pregnant or within 42days following termination of pregnancy, regardless of the duration and site of the pregnancy. The death was a result from pregnancy but not accidental causes.
Differentiate between direct and indirect obstetric death
Direct obstetric death is death resulting from obstetric complications of pregnancy state, incorrect treatment and intervention WHILE Indirect obstetric death is death due to pre-existing or pregnancy acquired disease and are not due to direct obstetric causes
Defined as deaths from unrelated causes which happened to have occurred in pregnancy or puerperium
Coincidental
What are the leading causes of maternal death in Botswana
Haemorrhage ( 28%)
Eclampsia (16%)
Abortion ( 11%)
List 4 approaches to measure maternal mortality
Civil registration system
Verbal autopsy
Census
Maternal mortality reviews
List any 5 of the top ten leading causes of maternal death
Severe pre-eclampsia
Rupture of the uterus during labor
HELLP syndrome
Viral diseases complicating pregnancy, childbirth, and the puerperium
tubal pregnancy
List any 4 interventions that can be adopted to reduce maternal morbidity and mortality
Early registration of pregnancy.
Community education through all platforms.
Prevent unwanted pregnancies ( use of contraceptives).
Maternal Mortality Audits and implementation of recommendations.
Encirclement of the widest diameter of the fetal head by the vulvar ring
Crowning
When to consider episiotomy?
*Risk of severe perineal tear
*Large baby
*Shoulder dystocia
State the signs of placental separation
*Uterus becomes globular and firm
*There is a sudden gush of blood
*Umbilical cord protrudes farther out the vagina
State 5 neonatal difficulties that may arise at birth.
*Lack of respiration effort
*Blockage of airways
*Impaired lung function
*Persistent increased pulmonary vascular resistance/ persistent pulmonary hypertension
*Abnormal cardiac structure
