normal labor ( basics) part 1

Question 1

Normal labor

Answer 1

**>37 weeks

**Labor is painful contractions, leading to
cervical changes including dilatation and
effacement (thinning ), till expulsion of the fetus

**this stages should be spontaneous without any medication

Question 2

the 10 most common signs of labor

Answer 2

1) nesting ?
2)lightening-a feeling that baby has dropped
3)contractions:mild-strong(early-active labour)
4)effacement -thinning of the cervix
5) dilation -widening of the cervix opening (in digital examination)
6) loss of mucous plug
7)leg cramping
8)back pain or pressure
9)nausea
10) water breaking

Question 3

mucus plug ?

Answer 3

a thick membrane covers the cervical opening and separate an protect internal environment from external
it is progesterone induced

Question 4

Fetal lie

Answer 4

the relationship between the axis of the fetus to that of the mother

Longitudinal / cephalic or breech
✓ Transverse
✓ Oblique

Question 5

fetal presentations are :

Answer 5

*vertex /cephalic
*face
*brow
*buttocks
*shoulder

Question 6

Fetal attitude:

Answer 6

1. Flexion
2. Extension
3. Hyperextension (could be seen in goiter)

Question 7

Station

Answer 7

Head descent according to
sacrospinous bone

ischial spine = level 0
above ischial spine (-)
below ischial spine (+)

(-) CI to vacuum

Question 8

bishop score :1-3 points

Answer 8

**cervical dilation :
1: (1-2), 2: (3-4), 3: (5-6)

**cervical effacement % :
1: (40-50) 2:(60-70)
3: (>80)

**station of presentation
1) -1,-2
2)0
3) +1,+2
** consistency of cervix :
1) medium 2) soft

**position of cervix
1) middle 2) anterior

Question 9

how to decide if the cervix favorable or not to electively induce labor ?

Answer 9

** by bishop score
** if >8/9 points -favorable cervix

**if < 6 point -unfavorable

Question 10

bishop score mnemonic

Answer 10

B-bishop
I-iffacement
S-station
H-hard or soft (consistency)
O-opening (dilation)
P-presenting part (position)

Question 11

Labor
induction
may be
performed
in several
methods

Answer 11

**if favorable cervix :
-IV oxytocin transfusion
- membrane manipulation

** unfavourable cervix :
Cervical ripening-
Prostaglandins (e.g. misoprostol)- vaginally or intra-cervically(not IV)
* Laminaria (hygroscopic rods which absorb moisture and expand)
into the internal os
* Foley catheter into the cervical canal(Balloon)

Question 12

1st stage of labor

Answer 12

1st stage: from onset of labor to full dilation of the cervix (10 cm)—
has 2 phases:
*latent phase: irregular contractions leads to dilatation of (4-6 cm )

• active phase : regular contractions leads to fully dilatation ( 10 cm)

Question 13

2nd stage of labour

Answer 13

is the time from full cervical dilation to delivery of the fetus

Question 14

3rd stage of labour

Answer 14

begins after delivery of the infant and ends with delivery of the placenta