Maternal systematic adaptations in the intrapartum period

Question 1

What are catecholamines?

Answer 1

Hormones such made by your adrenal glands that are released into the body in response to physical or emotional stress

Question 2

What are the three main types of catecholamines?

Answer 2

Dopamine
Norepinephrine
Epinephrine (adrenaline)

Question 3

What happens to the mother’s cardiovascular system during the intrapartum period?

Answer 3

Cardiac output increased due to:
pain
Increased heart rate
Increased circulation of catecholamines
Blood from the uterus going into circulation following contractions

Question 4

What volume of blood goes from the uterus into circulation following contractions?

Answer 4

300-500ml

Question 5

What percentage does cardiac output increase during the first stage of labour?

Answer 5

20%

Question 6

What percentage does cardiac output increase during the second stage of labour?

Answer 6

50%

Question 7

What can the increase in cardiac output within the intrapartum period lead to?

Answer 7

Increased blood pressure and respiratory rate

Question 8

How can the digestive system be impacted during the intrapartum period?

Answer 8

Some hospital policies state that nutrition of the mother should be restricted to prevent gastric aspiration during anaesthesia (Mendelson’s syndrome)

Question 9

What happens to the bladder of the mother during the intrapartum period?

Answer 9

It displaces into the abdominal cavity, causing retention of urine and difficulty passing urine

Question 10

If a mother has a full bladder during the intrapartum period, how will this impact her?

Answer 10

Increased pain
Reduced efficiency of uterine contractions
Delay the descent of the presenting part of the fetus

Question 11

If the uterus does not contract post birth, what risk does this pose?

Answer 11

Postpartum haemorrhage (PPH)

Question 12

What is the endocrine system responsible for during the intrapartum stage?

Answer 12

Providing the body with the correct balance of hormones for a successful birth

Question 13

What does fetal cortisol production do?

Answer 13

It increases at term which increases oestrogen production and the formation of oxytocin receptors on the uterine muscle

Question 14

What hormone is responsible for contractions?

Answer 14

Oxytocin

Question 15

What hormones are involved in labour?

Answer 15

Oxytocin
epinephrine and norepinephrine
Beta-endorphins
Prolactin

Question 16

What does the hormone oxytocin do in labour?

Answer 16

It brings on contractions
It has calming effects
It helps with pain

Question 17

What do beta-endorphins do during labour?

Answer 17

Act as a natural pain relief

Question 18

What does epinephrine and norepinephrine do in labour?

Answer 18

These are fight or flight hormones that can inhibit oxytocin, so it is important to keep these at a low level during labour

Question 19

What does the hormone prolactin do in labour?

Answer 19

This mothering hormone helps with breastfeeding, supporting the skin-on-skin contact with the baby immediately after birth