Flashcards in Normal Labour Deck (14):
What is labour?
Onset of regular and painful contractions with cervical dilation and descent of the presenting part
Signs of labour?
•regular and painful uterine contractions
•a show (shedding of mucous plug)
•rupture of the membranes (not always)
•shortening and dilation of the cervix
What are the 3 stages of labour?
•stage 1: from the onset of true labour to when the cervix is fully dilated
•stage 2: from full dilation to delivery of the fetus
•stage 3: from delivery of fetus to when the placenta and membranes have been completely delivered
What monitoring is done in labour?
•FHR monitored every 15min (or continuously via CTG)
•Contractions assessed every 30min
•Maternal pulse rate assessed every 60min
•Maternal BP and temp should be checked every 4 hours
•VE should be offered every 4 hours to check progression of labour
•Maternal urine should be checked for ketones and protein every 4 hours
What is stage 1 of labour? what happens?
Stage 1 - from the onset of true labour to when the cervix is fully dilated. In a primigravida lasts typical 10-16 hours
•latent phase = 0-3 cm dilation, normally takes 6 hours
•active phase = 3-10 cm dilation, normally 1cm/hr
What is stage 2 of labour? what happens?
from full dilation to delivery of the fetus
•'passive second stage' refers to the 2nd stage but in the absence of pushing (normal)
•active second stage' refers to the active process of maternal pushing
•less painful than 1st (pushing masks pain)
•lasts approximately 1 hours
•if longer than 1 hour (can be left longer if epidural) consider Ventouse extraction, forceps delivery or caesarean section
•episiotomy may be necessary following crowning
•associated with transient fetal bradycardia
What is CTG?
Records pressure changes in the uterus using internal or external pressure transducers
Normal fetal HR?
Causes of a baseline brady?
Increased fetal vagal tone, maternal beta-blocker use
Increased baseline Hr on ctg?
Maternal pyrexia, chorioamnionitis, hypoxia, prematurity
What can cause a loss of baseline variability?
What casuese early decelerations?
Usually an innocuous feature and indicates head compression
What casues latedecelerations?
Indicates fetal distress e.g. asphyxia or placental insufficiency