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Flashcards in normal labour Deck (32):
1

what is normal labour

painful regular uterine contractions with cervical effacement, dilation and descent of the presenting part

2

what is stage 1 labour split into

latent and established phase

3

what happens in the latent phase stage 1

before 3-4cm dilated.

4

what happens in active phase stage 1

>4cm dilated up to 10cm

5

length of stage 1 in primip

8-18h

6

length of stage 1 in multip

5-12h

7

what should be monitored in stage 1

temperature and bp 4hourly, pulse hourly, observe contractions every 30 mins. listen to FHR every 15 mins for 1 min after contraction

8

rate of dilations

after 4cm - 0.5cm/hr

9

when does the second stage begin

when the cervix is dilated to 10cm - through to delivery of the fetus

10

what are the stages of the 2nd stage

passive and active

11

what happens in passive phase of 2nd stage

cervix fully dilated but no desire to push

12

what happens in the active phase of 2nd stage

full dilatation and expulsive contractions. baby can be seen

13

what should be monitored in stage 2

pulse and bp hourly, temp 4 hourly, contractions every half hour. listen to FHR every 5 mins for 1 min after contraction

14

how long does stage 2 last in primp and multip

3h - primip, 2h- multip

15

what is the 3rd stage labour

delivery of the placenta

16

what size does uterus contract to after birth

17

what happens in stage 3

uterus contracts to

18

what can be used as the anterior shoulder is delivered

ergometrine + oxytocin (syntometrine)

19

what does using syntometrine do to third stage

decreases the time to 5 min and decr incidence PPH

20

when is syntometrine contraindicated

pre eclampsia, hypertension, liver/renal impairment/ heart disease, hypercholesterolaemia. as can precipitate myocardial infarction

21

if BP hasn't been measured and want to use a drug during labour what can you use

oxytocin

22

what hormones trigger onset of labour

prostaglandins and oxytocin- uterine contractions and cervical softening

23

what is a show

plug of cervical mucus and some blood as membranes strip from the os

24

what is rupturing of membranes

rupture of amniotic sac

25

why is vaginal exam performed

fetal engagement, cervical effacement, dilatation

26

what part of skull should be felt anteriorly

posterior fontanelle

27

what can be used to measure progress of labour in first stage

Bishops score

28

what is the bishops score based on

cervical length, dilatation, consistency, position of cervix, station of presenting part

29

when is the active phase in score of Bishops score

>11

30

which stage is hypoxia more common

2nd stage - fetal blood reduces and anaerobic resp with each contraction

31

active management stage 3 to reduce risk PPH

IM oxytocin as babies shoulder is delivered, cord traction with uterine stabilisation, early cord clamping

32

what should be done if there is retained placenta

manual removal