Labour

Question 1

What are the 4 phases of labour?

Answer 1

Latent phase
Active phase
Transition
Pushing

Question 2

Which phases occur in the first stage of labour?

Answer 2

Latent phase
Active phase
Transition

Question 3

Which phase overlaps between the second and third stages of labour?

Answer 3

Pushing

Question 4

What dilation is the cervix during the latent phase?

Answer 4

0-3cm

Question 5

What dilation is the cervix during active phase?

Answer 5

3-7cm

Question 6

What dilation is the cervix during transition?

Answer 6

7-10cm

Question 7

What dilation (cm) is fully dilated?

Answer 7

10cm

Question 8

What is the term to describe when the fetus finds the best way to fit inside the pelvis?

Answer 8

Best fit

Question 9

What two things can make the mechanism of labour problematic?

Answer 9

The curve of the birth canal due to walking upright

A large fetal head due to brain development

Question 10

What are 5 features of a gynaecoid pelvis?

Answer 10

Inlet is transversely oval
Pelvic cavity is roomy and shallow
Sacrum is broad and curved
Sub pubic angle is 90 degrees
Ischial spines are blunt

Question 11

What are 5 diameters of the pelvic brim?

Answer 11

Transverse
Left oblique
Right oblique
Anterior 
Posterior

Question 12

What is the pelvic brim?

Answer 12

The edge of the pelvic inlet

Question 13

What is the curve of the sacrum in the pelvis referred to as when describing the mechanism of labour?

Answer 13

The curve of carus

Question 14

What area of the skull is located: 
 At the back of the head?
At the front of the head?
Between the two?
Transversely across the skull?

Answer 14

Posterior fontanel
Anterior fontanel
Sagittal suture
Biparietal

Question 15

What is the general diameter of the biparietal?

Answer 15

9.5cm

Question 16

In order, what are the 6 steps in the mechanism of labour?

Answer 16

Engagement 
Decent and flexion
Internal rotation
Extension
External rotation
Lateral flexion

Question 17

What happens during engagement?

Answer 17

The Transverse diameter of the head descends through the pelvic brim

Question 18

How to you describe engagement?

Answer 18

5ths palpable

Question 19

What 8 things do you check for in a VE?

Answer 19

In vagina:
Dilatation of cervix (cm)
Consistency of cervix
Length of cervical canal (effaced)
Position of cervix 
In cervical os:
Station of presenting part 
Presentation
Position
Membranes (in tact?)

Question 20

What are the three consistency’s of a cervix?

Answer 20

Soft, medium, hard

Question 21

What is a membrane sweep?

Answer 21

Separating the membranes of the amniotic sac to attempt to bring on labour to avoid going overdue

Question 22

ARM

Answer 22

Artificial rupture of membranes

Question 23

FSE

Answer 23

Fetal scalp electrode

Question 24

What is umbilical cord prolapse?

Answer 24

When the umbilical cord drops through the open cervix into the vagina ahead of the baby

Question 25

What is placenta praevia?

Answer 25

When the placenta is lying unusually low in your uterus, next to or covering your cervix

Question 26

DR. C BRAVADO

Answer 26

``` DR- define risks C- contractions BRa- Baseline Rate V- variability A-accelerations D-decelerations O- overall impressions ```

Question 27

Why should you expect accelerations on a CTG?

Answer 27

Because during contractions, oxygen levels fall and CO2 levels rise temporarily so heart rate increases to deliver enough oxygen but between contractions they return to normal

Question 28

4 features of a normal CTG?

Answer 28

Baseline rate- 110-160 BPM Baseline variability- 5BPM or more Accelerations present No decelerations

Question 29

What is the usual baseline rate for a CTG?

Answer 29

110-160 BPM

Question 30

What is a reassuring baseline variability?

Answer 30

5BPM or more

Question 31

What is the definition of an acceleration?

Answer 31

15BPM above baseline lasting 15 seconds or more

Question 32

What is the definition of decelerations?

Answer 32

Slowing of the fetal heart rate below the baseline of 15BPM for 15 seconds or more

Question 33

In what instances may you catheterise a woman?

Answer 33

Prior to a C- section Prior to an instrumental delivery If woman is unable to pass urine during labour Urinary retention

Question 34

Risks of catheterisation

Answer 34

Infection Blocked catheter Bladder trauma

Question 35

What may you document after catheterisation?

Answer 35

Consent

Question 36

What are 3 aims of VE’s during labour?

Answer 36

Assess progress Perform ARM Identify fetal position

Question 37

When would you refrain from giving a VE?

Answer 37

Lack of consent Antepartum haemorrhage Preterm labour

Question 38

What are the three positions of the cervix on VEs?

Answer 38

Anterior, central, posterior

Question 39

What should you check following VE?

Answer 39

Fetal heart (and mother’s pulse)

Question 40

What landmark of the spine has the fetal head reached when it is described as 0?

Answer 40

Ischial spines

Question 41

The third stage of labour can be managed in two ways, what are these referred to as?

Answer 41

Active management | Physiological management