Week 6- Labour Flashcards
what is the mechanisim on labour onset?
Foetus releases cortisol
decrease progesteron and increase in estorgen
increased estrogen makes uterus suseptible to oxytocin
oxytoicin leads to contraction
what are the premonitory signs of labour?
Braxton Hicks contractions increaes pelvic pressure and congestion decent of foetus into pelvis relaxed pelvic floor cervical effacements static weight or weightloss rupture of membranes
what is the defintion of frist tage labour?
progressive effacement and dilation of cervix from 0cm to 10 cm
2 phases- cx 3-4cm
acttive cx >3cm to 10cm
what does the term effacement refer to?
the shortening of the cervix until it become part of the lower uterus
what happens in the latent phase of first stage labour?
3-8 hours
cervix dilates to 3cm - 4cm
cervix effaces 3cm to 0.5cm
contractions are starting irregulary and becoming more regular
slow increase in strenght, length and frequency
what occurs in the active phase of first phase labour?
more rapid dilation begins at 3-4cm compeltes at 10cm regular painful contractions - longer stronger, dilates at about 1cm per hour usually 3 contractions in 10minutes rarely longer than 60 seconds
what is true labour?
progressive dilation and effacement of the cervix
contractions regular and increasing in frequency and intensity
for many, discomfrot radiates from back to abdomen
pain not relaved by ambulation
decsnt of head
what is spurious labour?
contractions do not produce progressive cervical effacement and dilation
contractions irregular and dont increase in frequency
there may be tightness rather than pain
discomfort in lower abdomen and groin
discomfort improves when ambulating
what are the 5 ps of labour?
Passenger - foetus powers- primary uterine - second maternal effort postion- foetal postion passage- pelvis pshycological- maternal reaction
what can effects can the passanger have on labour
SIze of baby- particularly the head
foetal life of baby
foetal attitude
presenting part
what are the pwers in the stages of labour?
contractions; 1st stage- uterine contracctions
secondary stage- mpothers ability to push
what affects the passage
the type of pelvis
and soft tissues- cervix, uterus, vagina and perineum
what causes pain in labour?
contractions- dilation of cervix
streching of vagina and perineum
pressure of baby as it decends on pelvic floor
what are the normal vaginal losses during labour?
liqour/amniotic fluid- clear, muconium stained, blood stained
Operculum-show- muscus, blood
bleeding
what is the second stage of labour?
from end of first stage to birth of the baby
what is the transitional phase?
loss of control, cant do it anymore, fear, disorientation, nausea, shivering, demanding pain releif, voilisation
what is the passive phase?
stage in second stage labour
initally a lull- calm before the strom
contractions change characteristic becomes shorter and stronger
begining of involunatry expulsive contractions
no need or urge to push
foetus head is still high in pelvis
what is the active phase in second stage labour?
phase in second stage labour pushing urge varies- becomes uncontrollable changes in voclisation- grunting unctrollable urge to push urge to defecate pouting anus perineum buldges foetual head is lpw and visable
what are the presumtive recogitiong of 2nd stage labour?
presumtive
show, rupture, uncontrolaable urge to push, anal dilation, perineal buldging, anal cleft- red line
what are the definitive singes of 2nd stage of labour
Head on veiw
VE- cervix full dilated
what is the phsiology of second stage labour?
primary- uterus contracting and retracting pushing baby doiwn
foetal axis causes pressure
displacemnt of pelvic floor- anterorly bladder pushed up
posterorily the rectum becomes flattened into sacral curve
secindary- voluntar muscles of diaghram and abdomen all assist in expulsion
what is the ferusons reflex?
the uncontrollable urge to push
what are the cardinal movements?
Engagment descent flexion interal rotation extension external rotation expulsion
what is engagment?
Entering the widest diameter of the foetal presenting part through the plane of the pelvis/pelvic inlet
What is decent?
movement deep into the pelvic cavity- occurs during passive phase due to uterin contractions
what is flexion?
foetus chin to chest
this is then the smallest diameter of the babys head presents to the pelvis
what is internal rotation?
rotation of foetus head- face towards mums bum
as head reashes pelvic floor it rotates so that the shoulders can pass through the widest part of the pelvic inlet
at the inlet diameter is widest from right to ledt
at the pelvic outlet the diameter is widest from front to back
what is extension?
at the end of inteanal rotation the the baby extens its head
what is ec=xternal rotation/restitution?
foetus head is out of vagina, foetus turns to face inside of mums thighs
what is expulsion?
once shoulders are positioned AP the anterior shoulder and then posterior shoulder is delivered
