Machanism of labour - GM

Question 1

first stage of labour

Answer 1

cervix starts to soften and open
ends when there is full cervical dilatation and effacement

Question 2

second stage of labour

Answer 2

commences with complete cervical dilatation and ends with delivery of the fetus

Question 3

third stage of labour

Answer 3

initiates after the fetus is delivered and ends when the placenta is delivered

Question 4

discomforts of pregnancy

Answer 4

nausea and vomiting
fatigue
constipation
haemorrhoids
insomnia
heartburn
backache
varicosities

Question 5

solutions for nausea and vomiting

Answer 5

small frequent meals, low fat, dry carbohydrate before rising, keep hhydrated, ginger
more severe is called hyperemesis gravidarum

Question 6

constipation during pregnancy is caused by

Answer 6

slowing of gut motility

Question 7

changes in the fetus during labour

Answer 7

anterior pituitary gland releases adrenocoticotrophic hormone to stimulate the adrenal gland to produce glucocorticoids and androgens

Question 8

changes in the mother during labour

Answer 8

decrease in progesterone increases uterine sensitivity to stretching
increase in prostaglandins from the placenta increases uterine contractions, uterine sensitivity to oxytocin, and softening of cervix

Question 9

is rupture of membranes a true indicator of labour

Answer 9

no - unless cervical change is present

Question 10

latent vs active labour

Answer 10

latent - time between start of contractions to cervix openng 4cm
active - between 4-10cm

Question 11

parts of the second stage of labour

Answer 11

full dilation of cervix until birth
propulsive phase - full dilation with descent of the fetal head to the pelvic floor, no maternal urge to push
expulsive phase - maternal effort, bearing down resulting in birth

Question 12

posterior labour

Answer 12

longer labour - because it takes longer to rotate
baby may not sit well on the cervix - less likey to promote cervix to dilate

Question 13

reasons to perform vaginal assessments

Answer 13

baseline on admission
before administering analgesia
to confirm full cervical dilatation
fetal distress
to determinne best method of induction of labour depending on cervical length and position
usually performed 4 hourly to assess progress

Question 14

if the patient is pushing to early

Answer 14

if the patient is getting the urge to push while the cervix is still present/palpable, the pushing against the cervix can cause cervical oedema, which will slow down labour
advise patient not to push until the cervix is no longer palpable, this may reuire pain relief or channge of position to remove pressure off the back passage so that they no longer feel the urge to push.