Normal Labour + Abdominal PE Flashcards
(25 cards)
What are the 4 stages of normal labour?
The three stages of normal labour are the first stage (dilation), the second stage (expulsion), and the third stage (placental delivery). Lastly, the fourth stage: 1-4 hours post delivery.
True or False: The first stage of labour is characterized by the delivery of the baby.
False: The first stage of labour is the dilation of the cervix to 10 cm.
Fill in the blank: The average duration of the first stage of labour for first-time mothers is typically ______ hours.
12 to 14 hours.
What is the main purpose of the second stage of labour?
The main purpose of the second stage of labour is the expulsion of the fetus through the birth canal.
Multiple Choice: Which of the following best describes the third stage of labour? A) Dilation of the cervix B) Delivery of the baby C) Delivery of the placenta D) Recovery phase
C) Delivery of the placenta.
How many cm per hour should the cervix dilate in the active phase of labor? (Primip vs Multip)
1cm/hr(primip) OR
@ least 2cm in 4 H
Multip: 1.5cm/hr
Good contraction rate for Primips and multips?
3-4 in 10 mins
Definition(keywords) of normal labor? [3]
1) Onset of painful regular uterine contractions
2) progressive dilatation of the cervix
3) descent of the presenting part of fetus
Definition of first stage of labor.
Divided into latent, active and transition phase. Onset of coordinated contractions leading to complete dilatation of the cervix at 10cm
Latent phase definition.
Irregular contractions become coordinated; cervix effaces and dilates to 4 cm (3cm-MSIA CPG)
Active phase of first stage labor definition.
Cervix dilates from 4cm to 10cm.
First stage duration for:
a) Primi:
b) Multip:
a) Primi:12h
B) 7-8h OR LESS
The 4 signs and symptoms patient is in labor.
1) Amniotic fluid leakage
2) Show(blood and mucus)
3) Painful uterine contractions
4) PV bleed
What is hands off and hands on technique (in 2nd stage of labor)?
Hands off: Or hands poised is allowing the birth to occur naturally without intervention
Hands on: to apply pressure on fetal head and perineum; to control speed of delivery
Research suggests both outcome for perineal tears are the same: more tears a/w hands on
Inspection (PE) of pregnant mother (abdomen)
1) Distended abdomen w/ gravid uterus:
- Linea nigra
- Striae albicans
- Striae gravidarum
2) Umbilicus:
- Centrally/ quadrant(?) located
- Inverted/everted/flat (pregnancy is usually everted)
3) Scar
- Laparoscopic scar: location?
- Pfannenstiel incision (low transverse abdominal incision approx. 2 to 3 cm above the pubic symphysis.
- Well healed? bleeding? Pus? Keloid? Open sutures?
- measurement (use tape)
Superficial palpation (PE) abdomen of pregnant female.
- Soft/hard; tender/ non tender
- CONTRACTIONS?
- Increased temperature (Chorioamnionitis/ placental abruptio/uterine rupture/peritonitis/SSI)
-Fetal movements? appreciated?
Uterus (Leopold manoeuvre) list of findings.
- Gestation: Singleton/twin/triplet/quadruplet
- Lie: Longitudinal/ oblique/ transverse
- Presentation:
- fetal back on maternal left/Right
- CFH
- SFH (?cm)
- Liquor: adequate/inadequate
-EFW
-Fetal doppler HR
Presentation can be? (5)
- Vertex
- breech
- Shoulder
- compound (vertex & hand)
- Funic (umbilical cord)
CFH; estimate how?
PS:12W
Umbilicus 20W
Xiphisternum 36
below xiphi+ fullness : 40W
EFW, estimate how?
28 wks:1kg
32wks:2kg
1 hand:0.5kg
Always complete examination by measuring? (1)
Blood pressure
What other PE to do for pregnant mother or offer to her?
- Breast examination
- Respiratory
- Cardiovascular
End exam by checking feet/legs for?
- Bilateral calves: soft? non-tender? hard? tender?
- Pedal oedema? up to?
(Physiology): Pedal oedema in pregnant mothers:
a) d/t physiologic reasons (3)
b) d/t pathological reasons (3)
a) gravid uterus compression on veins; hormonal changes changing vascular permeability; Increased blood volume
b) Pre-eclampsia, DVT, cardiac/renal disease
