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Obs AM > Normal labour > Flashcards

Normal labour Flashcards

1
Q

What is the physiology of initiation of labour?

A

Progesterone decreases
Oxytocin and prostaglandins increase
Cervix softens
Myometrial tone changes allow for coordinated contractions

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2
Q

What is stage 1 labour?

A

Dilatation and effacement of cervix to 10cm

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3
Q

What are the stages of stage 1 labour?

A 
Latent= intermittent irregular contractions allow for some effacement and dilatation up to 4cm 
Established= regular contractions --> progressive effacement and dilatation up to 10cm
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4
Q

What is the contraction ratio in established stage 1?

A

3-4/10 mins, lasting 40-60s

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5
Q

What is the duration of stage 1 labour in a prim?

A

Average 8

Max 18

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6
Q

What is the duration of stage 1 labour in parous?

A

Average 5

Max 12

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7
Q

What is failure to progress in labour?

A

Prim <0.5cm/hr

Parous <1cm/hr

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8
Q

What is stage 2 labour?

A

From full cervical dilatation until birth

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9
Q

What are the stages of stage 2 labour?

A 
Passive= full cervical dilatation but no expulsive contractions 
Active= expulsive contractions with maternal effort and fully dilated cervix
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10
Q

What is the duration and purpose of passive stage 2?

A

~1 hour

Allow for further foetal descent

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11
Q

What is the duration of active stage 2?

A 
Prim= 2 hours 
Parous= 1 hour
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12
Q

At what stage should forceps/Ventouse/section be considered?

A

After 1-2hours active labour

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13
Q

What is stage 3 of labour?

A

From birth of baby until expulsion of placenta and membranes

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14
Q

What are the ways to manage stage 3?

A

Active- if long/induced labour, ~30 mins

Physiological ~1 hour

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15
Q

What does active management of stage 3 involve?

A

Uterotonic drugs= syntometrine
Deferred clamping and cutting of cord
Controlled cord traction after separation of placenta

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16
Q

What is syntometrine?

A

Combination of syntocin and ergometrine
IM injection
Contraindicated in pre-eclampsia/hypertension

17
Q

What is the physiological management of stage 3?

A

No clamping of cord until pulsation stopped
Delivery of placenta by maternal effort
Up to 60 mins

18
Q

How often should foetal heart beat be monitored?

A

Stage 1= 15 mins

Stage 2= 5 mins

19
Q

What are the indications for continuous CTG?

A 
Suspected infection, temp >38 
Hypertension >160/110 
Oxytocin 
Significant meconium 
New vaginal bleed
20
Q

What are the normal foetal positions during labour?

A
  1. Engagement of foetal head in transverse position
  2. Descent and flexion
  3. Internal rotation to occipital-anterior
  4. Delivery by extension
  5. Rotation to transverse for delivery of shoulders

Obs AM (17 decks)

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