3rd & 4th Stage of Labour Flashcards
(27 cards)
Define 3rd Stage of Labour
its the period following the birth of the baby and birth of placenta and ends with control of bleeding
What does skin to skin do
it releases oxytocin and helps facilitate the separation of placenta and membrane and assists in control bleeding
what pains can you expect from birthing placenta
low pelvic pain, contractions as placenta detaches from uterine wall.
What is a lotus birth
placenta is left attached to baby after birth and cord not cut-placenta is then dried, salted and wrapped
What is the purpose of uterotonic agents
medications used during 3rd stage of labour to prevent or manage postpartum hemorrhage-they promote effective uterine contractions
what are the common uterotonic agents
Oxytocin
ergometrine
misoprostol
Syntometrine (oxytocin and Ergometrine combination)
What is the dosage of Oxytocin
10 IU-IM
gives rapid contraction of smooth muscle tissue
What is the dosage of Ergometrine
0.2mg-IM
When should oxytocin be administered
immediately following birth of baby-clamp and cut cord and administer in the leg
Examination of Placenta
Amnion-fetal surface, amniotic fluid
Examine umbilical cord for 1 vein and 2 arteries, length, attachment site in placenta
What is the 4th stage of labour?
its the immediate postpartum period which lasts for 1-2 hours after delivery of placenta
What is involution
uterus retuning to pre pregnancy state-each day involutes by 1cm
What maternal assessments need to be conducted
Vital signs-within normal ranges
check tear of perineum
Uterus tone and height
fundus should be firm and central between umbilicus and pubic bone
Bladder care
Check for bleeding
What are the physiological and active management methods of the third stage of labor?
Physiological management: The natural process of waiting for the placenta to deliver without any medical intervention.
Active management: Involves administering uterotonic agents (e.g., oxytocin), controlled cord traction, and massaging the uterus to prevent postpartum hemorrhage and ensure the placenta is delivered.
What is the difference between early cord clamping and delayed cord clamping?
Early cord clamping: The cord is clamped within 1-3 minutes after birth.
Delayed cord clamping: The cord is left intact for at least 1-3 minutes to allow the baby to receive additional blood from the placenta, which can improve newborn health outcomes.
What are the signs of placental separation, and why is palpation and uterine massage important?
Signs of placental separation: A gush of blood, lengthening of the umbilical cord, and a change in the shape of the uterus (becoming more globular).
Palpation and uterine massage: These actions help ensure the uterus is contracting properly and assist in preventing hemorrhage by encouraging the placental separation process.
How do you define and identify perineal tears
Perineal tears are lacerations that occur in the perineum during childbirth. They are classified into grades (1st, 2nd, 3rd, and 4th degree), with higher grades involving deeper tissues. Identification involves visual examination
What are the immediate physiological changes in the uterus post-birth?
After birth, the uterus contracts to reduce its size, expel any remaining placental tissue, and minimize blood loss. This contraction also aids in the sealing of blood vessels at the site where the placenta was attached.
How does the baby adapt from intrauterine to extrauterine life, and what is the clinical use of the APGAR score?
The baby adapts by initiating breathing, adjusting to external temperatures, and circulating blood differently. The APGAR score evaluates the baby’s overall condition (heart rate, respiratory effort, muscle tone, reflex response, and color) at 1 and 5 minutes after birth.
What is the midwife’s role in newborn care immediately following birth?
The midwife ensures that the newborn is breathing properly, provides immediate assessments (APGAR), supports thermoregulation through skin-to-skin contact, and monitors for any early complications.
Why is thermoregulation important, and how is immediate skin-to-skin contact beneficial?
Thermoregulation is crucial to prevent hypothermia. Skin-to-skin contact helps stabilize the baby’s temperature, promotes bonding, and encourages early breastfeeding.
What are the recommendations for Vitamin K and Hepatitis B immunization for the newborn?
Vitamin K: Administered to prevent vitamin K deficiency bleeding (VKDB), typically within the first few hours of life.
Hepatitis B immunization: Given as the first dose of the Hepatitis B vaccine, ideally within the first 24 hours after birth, to protect against Hepatitis B infection.
What are the indications for using active management of the third stage of labor?
Active management is recommended for women at higher risk of PPH, such as those with multiple pregnancies, previous PPH, or prolonged labor. It is also standard care in most settings to reduce the risk of hemorrhage and facilitate the delivery of the placenta.
How does the choice of uterotonic agent depend on the clinical context?
The choice of uterotonic (oxytocin, ergometrine, misoprostol, carbetocin) depends on factors like the woman’s health history (e.g., hypertension), the clinical setting (e.g., home birth vs. hospital), and drug availability. Each agent has unique benefits and risks for both the mother and the baby.
