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Week 114 - Pregnancy > Normal labour > Flashcards

Normal labour Flashcards

1
Q

What is labour?

A

Process of birth

Includes the expulsion of fetus and the placenta

3 stages of unequal length

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2
Q

What are the three stages of labour?

A

First stage: onset of labour - cervix fully dilated

Second stage: full dilation - delivery of baby

Third stage: Expulsion of placenta and membranes

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3
Q

Describe the first stage of labour

A

Contractions - cervix fully efaced

Cervical dilation

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4
Q

Describe the second stage of labour

A

Propulsive: full dilation with head to pelvic floor

Expulsive: irresistable desire to bear down/push = delivery

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5
Q

Describe the third stage of labour

A

Cord lengthens

Gush of blood

Fundus of uterus rises

Controlled cord traction

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6
Q

Describe the mechanism of normal labour

A

Head at pelvic brim in left occipito lateral position

Neck flexes and presenting diameter is suboccipito bregmatic

Head hits pelvic floor - Occiput rotates => Occipito anterior

Head delivers by extension

Head restitutes (comes in line with shoulders)

Descent continues and shoulders rotate into the AP diameter of the pelvis

Anterior shoulder slips under pubis and with lateral flexion baby is born

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7
Q

What is normal labour characterised by?

A

Regular painful uterine contractions

Dilation of cervix

Descent of head

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8
Q

What are some of the other associates symptoms with labour?

A

A “show” (operculum) = a blood stained mucus discharge
- 2/3 of women by onset of labour

Spontaneous rupture of membranes
- 1/3 of at onset of labour

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9
Q

What are the cardinal signs of labour during the process of birth?

A

Effacement

Dilation of cervix (external orifice of the uterus)

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10
Q

What is a primigravid labour and what are the risks?

A

First labour

  • inefficient uterine action
  • risk of cephalopelvic disproportion/foetal trauma (rare)
  • rupture of uterus (never happens)
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11
Q

What is a multigravid labour and what are the risks?

A

Not first labour

  • Risk of uterine rupture
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12
Q

Define caput

A

Oedema at the head

  • due to pressure against rim of the cervix
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13
Q

Define moulding

A

Overlapping of the vault bones

  • shape of the skull bones alter so that the diameters shorten
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14
Q

Define engagement

A

Descent of biparietal diameter through pelvic brim

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15
Q

Define the lie of a foetus

A

Relation of long axis of foetus to mother’s vertebral column

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16
Q

Define presentation

A

The part of the foetus that is in the lower pole of uterus

17
Q

Define attitute

A

The posture of the foetus

  • flexion
  • deflexion
  • extension

Normal attitude is flexion when presentation is vertex

18
Q

Define position

A

The relationship of the presenting part to the mother’s pelvis
- e.g. left occiput anterior

The denominator is the abitrary part of presentation

  • occiput in vertex presentation
  • sacrum in breech presentation
  • mentum in face presentation
19
Q

When is the head engaged?

A

When head at level of ischial spines (unless of caput)

<= 2/5 palpable per abdomen

20
Q

What is cephalic presentation?

A

When the head is first foetal part in lower pole of uterus

i.e. vertex, sinciput, brow, face, chin

21
Q

What is breech presentation?

A

The opposite to a cephalic presentation

i.e. complete, footling, frank

22
Q

What is shoulder presentation?

A

Presentation of arm, shoulder, trunk first

23
Q

What is the station?

A

The relationship of the head to ischial spines
- ischial spines: station = 0

Above ischial spine => station -1, -2, …, -4cm

Below ischial spine => station +1, +2, …, +4cm

24
Q

What is syntocinon and what is it’s funtion?

A

Synthetic oxytocin

  • an octapeptide that causes rhythmic uterine contraction

Acts within 2 mins when given IV

25
Q

What is the function of Ergometrine?

A

Causes tetanic contractions (prolonged spasm)

Used for post partum haemorrhage

26
Q

What are the side effects and contraindications of Ergometrine?

A

SEs: N & V, hypertension

CIs: hypertension and CV disease

27
Q

What is syntometrine?

A

Syntocinon + Ergometrine

Used for the active management of third stage of labour

Given as the anterior shoulder appears under the pubic symphysis

28
Q

What are the different fetal diameters?

A 
Suboccipito bregmatic = 9.5cm (smallest)
.
.
.
Mento-vertical=  14cm (largest)
29
Q

List the five things measured for AGPAR score.

A

Skin colour

Muscle tone

Respiratory effort

Heart rate

Response to stimulus

Week 114 - Pregnancy (1 decks)

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