Normal Labour

Question 1

What is the first stage of labour?

Answer 1

Occurs when cervix is fullt dilated

Progresses by 0.5-1 cm/hr

Question 2

How is normal labour defined?

Answer 2

Spontaneous
Ocuurs at 37-42 weeks gestation
Fetus presents by the vertex
Results in a spontaneous vaginal birth

Question 3

What allows for the expulsion of the fetus?

Answer 3

Cervix softens

Myometrial tone changes to allow for coordinated contractions

Progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate

Question 4

What is stage 2 of labour?

Answer 4

Full cervical dilation to delivery of the baby

Question 5

When would the baby be expected to be delivered in a primi during the second stage of labour?

Answer 5

Within two hours of active labour

Question 6

When would the baby be expected to be delivered in a multigravita birth during the second stage of labour?

Answer 6

within one hour of active second stage labour

Question 7

What is stage 3 of labour ?

Answer 7

the time from the birth of the baby to the expulsion of the placenta and membranes

Question 8

When is the third stage of labour classified as being prolonged?

Answer 8

Within 30 mins with active management

Within 60 mins with physiological management

Question 9

How is normal positioning determined?

Answer 9

In relation to the occiput

Question 10

What is the normal mechanism of labour ?

Answer 10

Descent
Flexion
Internal rotation of the head
Crowning and extension of the head
Restitution
Internal rotation of the shoulders
External rotation of the head
Lateral flexion

Question 11

How do uterine contractions move across the uterus?

Answer 11

They start at the fundus and move down and acorss the uterus

Question 12

What do contractions enable in birth?

Answer 12

They exert pressure on the fetal pole which encourages flexion which in turn puts pressure on the cervix to thin and dilate

Question 13

What is the passive stage of labour?

Answer 13

The finding of full dilation of the cervix before or in the absence of involuntary expulsive contractions

Question 14

What is the active stage of labour characterised by?

Answer 14

Presenting part is visible
Expulsive contractions are present
There is active maternal effort

Question 15

What is the active management of the third stage of labour?

Answer 15

Routine use of uterotonic drugs, optimal cord clamping, controlled cord traction

Question 16

What is the physiological management of the third stage of labour?

Answer 16

No routine use of uterotonics, no cord clamping until pulsatuoin has stopped, delivery of the placenta by maternal