Flashcards in Normal Delivery And Labour Deck (31):
2 phases of first stage of labour?
Latent: slow progress to 3cm (variable duration)
Active: faster rate of dilation starts at 2-4 dilatation.
What is spurious labour?
No cervical effacement/dilatation
What is the 'membranes'?
What is in the membranes?
Fetus, placenta, amniotic fluid
Why ARM? 2 reasons
Increased prostaglandins (increase induction)
Idea of fetal well being: volume and colour-myconeum)
Labour needs 3 things
Powers: uterine contractions
Passenger: size, lie, presentation, attitude, position
Attitude of baby?
Degree of extension/flexion of fetal neck
Want them to flexed
Position of baby?
Relationship of nominated part of presenting part to location on maternal pelvis
Maternal well being during labour?
Pain relief non-pharma
Massage, relaxation, breathing, position, hot, cold packs
Pharma relief pain in labour?
Neuraxial: epidural/spinal, combined spinal/epidural
Local: pudendal nerve block, perineal infiltration
Blood flow placenta during contraction?
Reduced blood flow by 40% every contraction
How long is first stage of labour? S1 Nullipara/Multipara?
Nullipara: 6-18 Hrs.
Assess progress of labour
How many contractions in 10 minutes?
What is a partogram?
Graph that showed cervical dilatation progress
Second stage of labour Head changes in pelvis?
Shape - Moulding
Size - flexion
Position - rotation
When sutures come together/approximate each other other
when skull plates overlap
Suboccipital-bregmatic diameter is?
Face first: 9.5cm
must be Mental anterior
Varies with flexion of head
From OT to OA to help get through mid pelvis
What is bispinous in midpelvis?
Smallest diameter in pelvis - ischial spines
After head is out, then what?
Want to encourage them to have occiput transverse, then deliver anterior shoulder, then posterior shoulder, then rest of Bodyy
Third stage of labour Is?
Separation and expulsion of placenta within 5-10 minutes
Signs of separation of placenta?
Fresh show of blood from vagina
Lengthen gin fo umbilical cord
Uterus becomes firm
Gentle traction on cord
What is active management of Third stage of labour? Meds?
Ergometrine(profound smooth muscle contraction! Vomiting)
When need to go to theatre for tearing perineum?
3rd and 4th degree tear
So if it tears, it extends away from anal sphincter