First stage of labour (Complete) Flashcards
(9 cards)
Define first stage of labour
Beggining stage of labour starting with regular uterine contractions and ending when full cervical dilation of 10cm
What are the two phases of 1st stage of labour?
Latent phase: dilation 0-3cm
Active phase: dilation of 3-10cm
What is the normal rate of cervical dilation in primiparous women?
1cm every 2 hours
What is the normal rate of cervical dilation in multiparous women?
1cm every 1 hour
What is the underlying physiology 1st stage of labour?
Initiated by complex interplay of hormones but mainly:
Prostaglandins
Oxytocin
These promote uterine contractions
Combination of uterine contractions and exerted pressure from the pressenting part of the foetus promotes cervical dilation
What are the main signs/symptoms of first stage of labour?
Symptoms:
Regular and painful contractions
- Become more frequent and stronger over time
Passage of blood stained mucous (aka “show”)
- Signifies expulsion of mucous plug from cervix
Rupture of membranes (water breaking)
Signs:
Progressive cervical dilation (up to 10cm)
Descent of foetal head into pelvis
What differentials should be considered alongisde first stage of labour?
Braxton-Hicks contractions:
- Irregular and non-pogressive
- No cervical dilation
Preterm labour:
- If occuring < 37 weeks
What investigations should be condicted during first stage of labour?
Bedside:
Regular assessment of maternal vital signs
CTG: Monitor foetal status
Frequent examination to determine cervical dilation
Palpation to assess foetal position and descent
What is the management plan for patients in first stage of labour?
Analgesia:
- Opioids
- Nitric oxide
- Epidural anaesthesia
Encouraging mobility and positional changes to facilitate labour progression
Regular monitoring
Adequate hydration and nutritional support
