Child birth

Question 1

Obstetric examination

Answer 1

external signs; distension; fetal lie; presentation (part that occupies lower segment); engagement (how deep presenting part is in pelvis; fetal heart rate; ask for baby’s movements

Question 2

Has childbirth begun? (What is labour?) **

Answer 2

Painful uterine contractions and dilatation and effacement of cervix

Question 3

What are the three stages of labour?

Answer 3

1) cervix opens to full dilatation/ effacement
2) from full dilatation to delivery
3) baby delivery to placenta delivery

Question 4

What three mechanical factors is progress determined by?

Answer 4

Passenger: diameter of baby’s head
passage; dimensions of the bony pelvis
Power: degree of force of expelling baby

Question 5

What is special about a baby’s head?

passenger

Answer 5

Cranial bones are not fused, in between are sutures, and where sutures meet are fontanelles.

Where three of the sutures come together is the occiput. Reference point. position of occiput determines progress.

Question 6

How is a babys head position important?

passenger

Answer 6

The pelvis is oval, not round, so the best way to negotiate head delivery is in a transverse manner.

Note that the inlet and outlet are both oval, but differ by 180 degrees.

Question 7

Baby’s attitude

Answer 7

The degree of head flexion. The ideal is maximum flexion, and a small head diameter.

extension results in a larger diameter.

Question 8

Ischial spines

Answer 8

Point of refernce, if above them, caesarian is likely required (negative station)

Question 9

What influences power?

Answer 9

Oxytocin