Labour stages and obstruction Flashcards
How long does the latent phase of the 1st stage last?
Can last days
What should be the dilatation increase per hour in the active phase of the 1st stage?
1-2cm per hour
When would the 2nd stage of labour be classed as prolonged in a nulliparous woman with and without anaesthesia?
With anaesthesia - >3 hours
Without anaesthesia - >2 hours
When would the 2nd stage of labour be classed as prolonged in a multiparous woman with and without anaesthesia?
With anaesthesia - >2 hours
Without anaesthesia - >1 hour
How long does the 3rd stage of labour normally last?
10 mins
What is done if the 3rd stage of labour takes over an hour?
Preparation made for removal under GA
What can actively be done to try and progress the 3rd stage of labour?
Use oxytocic drugs and controlled cord traction
How long does the puerperium last?
6 weeks
What would class as suspected delay in stage one for a nulliparous woman?
<2cm dilation in 4 hours
What would class as suspected delay in stage one for a parous woman?
<2cm dilation in 4 hours
OR
slowing in progress
How do you assess the foetus (normally) during phase 1 of labour and how frequently?
Doppler auscultation of foetal heart
During and after a contraction
Every 15 minutes
How do you assess the foetus (normally) during phase 2 of labour and how frequently?
Doppler auscultation of foetal heart
At least every 5 minutes during and after a contraction for 1 whole minute
Check maternal pulse every 15 mins
What are the indications for cardiotocography (CTG)?
Small foetus Preterm/post dates Antepartum haemorrhage Hypertension/pre-eclampsia Diabetes Meconium Epidural VBAC (vaginal birth after caesarean) Premature rupture of membranes >24 hours Sepsis (temp >38*) Induction/augmentation of labour
What is the normal variability in the CTG?
5-25 bpm
Are decelerations always a sign of hypoxia?
No
If they are late (not timed with contractions) they are a sign of hypoxia
