22. Normal Birth Flashcards Preview

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Flashcards in 22. Normal Birth Deck (19)
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1
Q

initiation of labour

A

origin is unclear
multifactorial: hormonal, mechanical
foetal hypothalamus is triggered
maternal post pituitary releases oxytocin and decide releases prostaglandins

2
Q

physiology of labour initiation

A

increase in oestrogen (pro labour) and decrease in progesterone (pro pregnancy)
oxytocin and prostaglandins create uterine contractions
mechanical stimulation of uterus and cervix caused by over stretching and pressure

3
Q

stages of labour

A

latent phase
1st stage
2nd stage
3rd stage

4
Q

latent phase

A

effacement of cervix (shorts and thins)
contractions
intensity varies
preparation for labour: can last days

5
Q

diagnosing active labour

A

painful of active labour
effacement of cervix
dilatation of cervix to 4cm or more

6
Q

1st stage

A

active phase
established labour to full dilatation
vaginal examinations every 4 hours
average: 0.5cm per hour

7
Q

2nd stage

A

form full dilatation to delivery of the baby

8
Q

pelvic inlet

A

brim is oval, except where promontory projects

anteroposterior diameter = 12 cm

9
Q

pelvic outlet

A
diamond shaped 
3 diameters 
anteroposterior 
oblique
transverse
10
Q

fontanelles

A
anterior (bregma) 
- diamond shaped intersection of 4 sutures
- 2x3cm
- closes at 18 months 
posterior 
- Y shaped intersection of 3 sutures
closes at 6-8 weeks
11
Q

diameters of foetal skull

A

suboccipitobregmatic = 9.5cm - OA position
occipitofrontal = 11cm - OP position
supraoccipitomental = 13.5cm - brow
submentalbregmatic - 9.5cm - face

12
Q

mechanism of birth

A

head at pelvic brim, occipitotransverse position
flexion of neck
head descends and engages
head reaches pelvic floor, rotates to OA position
head delivers by extension
head ‘resititues’ - comes into line with shoulders
shoulders rotate into anterior/posterior diameter of pelvis
anterior shoulder delivered by lateral flexion
posterior shoulder by upward flexion

13
Q

3rd stage

A

delivery of placenta
normal blood loss = 300-500ml
inspection of placenta to ensure completion

14
Q

3rd stage active management

A

oxytocin given i.m. to maternal thigh
causes sustained uterine contractions
aids placental delivery
decreases risk of post parts haemorrhage

15
Q

3rd stage physiological management

A

mother naturally expels placenta and membranes with contractions

16
Q

foetal monitoring in labour

A

to detect foetal hypoxia and deliver baby if needed
intermittent auscultation
CTG
FBS

17
Q

intermittent auscultation

A

every 15 mins before and after contraction during 1st stage
every 5 mins in 2nd stage
any abnormality - use CTG

18
Q

cardiotocograph (CTG)

A

continuous print of foetal heart rate and contractions
abdominal ultrasound - detects cardiac movements, hence heart rate
clip applied to foetal scalp (FSE) - r-r wave of ECG

19
Q

foetal blood sampling (FBS)

A

used to check CTG findings

stab on foetal scalp, ph and base excess result