WEEK 5 🤱 EC 🌟

Question 1

Define 2nd stage of labour:

Answer 1

Phase between full dilation of the cervical os and the birth of the baby

Question 2

What is the passive stage of 2nd stage of labour

Answer 2

Fulll dilation of cervix prior to involuntary expulsive pushing and contractions

Question 3

What is the active stage of 2nd stage of labour

Answer 3

-Baby visible
-Full dilation
-Involuntary expulsive contractions + pushing.

Question 4

NICE guidlines on length of active stage of labour for most NULIparous women

Answer 4

-Birth expected to happen within 3hrs of active 2nd stage

-A diagnosis of delay shud b made when 2+hrs and operative vaginal birth suggested if birth not imminent

Question 5

NICE guidelines on length of active 2nd stage of labour for most Parous women

Answer 5

-Birth expected to happen within 2hrs of start of active stage

-Diagnosis of delay shud b made when its lasted 1hr, operative vaginal birth if birth not imminent

Question 6

How to recognise a woman in 2nd stage of labour

Answer 6

-Maternal behaviours
-External signs
-Rhombus of Michaelis’ (sacral bulge)
-Uterine action
-Urge to push
-VE (full dilation)

Question 7

What r some external signs of full dilation

Answer 7

-Perineum bulges
-Anus flattens (BO)
-Vagina begins to gape
-Presenting part visible
-Sacral bulge (Rhombus of Michaelis)

Question 8

How does fetal axis pressure aid in descent + engagement of fetus

Answer 8

Pressure transmits from fundus down long axis of back to the head

Increases flexion of head, pushing it inwards, resulting in smaller presenting diameters, faster progress + less trauma to mom + bb

Question 9

When should a woman start pushing?

Answer 9

Wait until fetal presenting part is at level of pelvic floor bfore encouraging maternal pushing efforts

AAny pushing b4 thus only exhausts the woman.

Question 10

Write a note on fergusons reflex: