Week 6- Labour

Question 1

what is the mechanisim on labour onset?

Answer 1

Foetus releases cortisol
decrease progesteron and increase in estorgen
increased estrogen makes uterus suseptible to oxytocin
oxytoicin leads to contraction

Question 2

what are the premonitory signs of labour?

Answer 2

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

Question 3

what is the defintion of frist tage labour?

Answer 3

progressive effacement and dilation of cervix from 0cm to 10 cm

2 phases- cx 3-4cm
acttive cx >3cm to 10cm

Question 4

what does the term effacement refer to?

Answer 4

the shortening of the cervix until it become part of the lower uterus

Question 5

what happens in the latent phase of first stage labour?

Answer 5

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

Question 6

what occurs in the active phase of first phase labour?

Answer 6

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

Question 7

what is true labour?

Answer 7

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

Question 8

what is spurious labour?

Answer 8

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

Question 9

what are the 5 ps of labour?

Answer 9

Passenger - foetus
powers- primary uterine
- second maternal effort
postion- foetal postion
passage- pelvis 
pshycological- maternal reaction

Question 10

what can effects can the passanger have on labour

Answer 10

SIze of baby- particularly the head
foetal life of baby
foetal attitude
presenting part

Question 11

what are the pwers in the stages of labour?

Answer 11

contractions; 1st stage- uterine contracctions

secondary stage- mpothers ability to push

Question 12

what affects the passage

Answer 12

the type of pelvis

and soft tissues- cervix, uterus, vagina and perineum

Question 13

what causes pain in labour?

Answer 13

contractions- dilation of cervix
streching of vagina and perineum
pressure of baby as it decends on pelvic floor

Question 14

what are the normal vaginal losses during labour?

Answer 14

liqour/amniotic fluid- clear, muconium stained, blood stained
Operculum-show- muscus, blood
bleeding

Question 15

what is the second stage of labour?

Answer 15

from end of first stage to birth of the baby

Question 16

what is the transitional phase?

Answer 16

loss of control, cant do it anymore, fear, disorientation, nausea, shivering, demanding pain releif, voilisation

Question 17

what is the passive phase?

Answer 17

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

Question 18

what is the active phase in second stage labour?

Answer 18

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

Question 19

what are the presumtive recogitiong of 2nd stage labour?

Answer 19

presumtive

show, rupture, uncontrolaable urge to push, anal dilation, perineal buldging, anal cleft- red line

Question 20

what are the definitive singes of 2nd stage of labour

Answer 20

Head on veiw

VE- cervix full dilated

Question 21

what is the phsiology of second stage labour?

Answer 21

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

Question 22

what is the ferusons reflex?

Answer 22

the uncontrollable urge to push

Question 23

what are the cardinal movements?

Answer 23

Engagment
descent
flexion
interal rotation
extension
external rotation
expulsion

Question 24

what is engagment?

Answer 24

Entering the widest diameter of the foetal presenting part through the plane of the pelvis/pelvic inlet

Question 25

What is decent?

Answer 25

movement deep into the pelvic cavity- occurs during passive phase due to uterin contractions

Question 26

what is flexion?

Answer 26

foetus chin to chest

this is then the smallest diameter of the babys head presents to the pelvis

Question 27

what is internal rotation?

Answer 27

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

Question 28

what is extension?

Answer 28

at the end of inteanal rotation the the baby extens its head

Question 29

what is ec=xternal rotation/restitution?

Answer 29

foetus head is out of vagina, foetus turns to face inside of mums thighs

Question 30

what is expulsion?

Answer 30

once shoulders are positioned AP the anterior shoulder and then posterior shoulder is delivered