Normal Labour and Delivery Flashcards Preview

Reproductive System > Normal Labour and Delivery > Flashcards

Flashcards in Normal Labour and Delivery Deck (28)
Loading flashcards...
1
Q

What is the definition of labour?

A

Normal physiologic process during which the foetus, membranes, umbilical cord and placenta are expelled from the uterus - most women experience without complications

2
Q

What is the WHO definition of normal labour?

A

Spontaneous in onset, low risk at the start of labour and remaining so throughout labour and delivery, the infant being born spontaneously in the vertex position between 37-42 completed weeks of pregnancy

3
Q

What is a low risk labour?

A

Labour in a woman without a pre-existing medical condition

4
Q

What labours does ‘spontaneous’ (in the WHO definition of normal labour) rule out?

A

Induced labours

5
Q

What is the normal labour time for prims?

A

12-18 hours

6
Q

What is the normal labour time for multips?

A

6-8 hours

7
Q

What might be mistaken for labour starting, but does not actually indicate the start of labour?

A

Braxton Hicks contractions - irregular, do not increase in frequency or intensity, “practice contractions”, don’t make any change to the cervix and are not sustained

Show - blood mucous plug from cervix, does not indicate start of labour, labour can occur weeks after this is expelled

PROM - pre-labour rupture of membranes, “waters broken”, can be a day or more before labour starts, or weeks if pre-term
Not all women will rupture membranes, some will deliver baby in the sac, some will rupture at the same time as giving birth

8
Q

What are the physiological factors that cause the initiation of labour?

A

Largely unknown

9
Q

When does labour occur?

A

When factors which inhibit contraction and maintain a closed cervix diminish and are succeeded by the actions of factors which do the opposite

10
Q

What brings about contractions?

A

An increase in intracellular free calcium

11
Q

What increase intracellular free calcium and therefore stimulate uterine contraction?

A

Prostaglandins and oxytocin

12
Q

What are the places where labour commonly occurs?

A

Labour ward - high intervention, acute medical setting, generally women are monitored, IV access
Midwives unit - low risk, low intervention, analgesia, pool births possible, intermittent auscultation, encourage mobility
Home - midwife has to attend
BBA

13
Q

What is the first stage of labour?

A

Begins with regular contractions and ends at full dilatation

14
Q

What is the second stage of labour?

A

Starts with full cervical dilatation and ends with the delivery of the foetus

15
Q

What is the third stage of labour?

A

Period between the delivery of the foetus and the delivery of the placenta and foetal membranes, can take 10 minutes-1 hour

16
Q

What is needed in order to labour effectively?

A

At least 4 strong contractions, lasting at least 40 seconds, in 10 minutes

17
Q

What are mild tone contractions?

A

Contractions lasting < 20 seconds

18
Q

What are moderate tone contractions?

A

Contractions lasting < 40 seconds

19
Q

What are you examining for when examining the station of the baby’s head?

A

Relation of baby’s head to ischial spine

Position of baby’s head - needs to be in the correct position for delivery

20
Q

What are the phases of the first stage of labour?

A

Latent

Active

21
Q

What is the latent phase of the first stage of labour?

A

Involves contractions which shorten the cervix and start dilatation

22
Q

What is involved in the initial evaluation of a woman in the first stage of labour?

A
Due date
When contractions started - frequency and pain
Any bleeding 
Movement of baby 
Observations
Foetal heart rate
Urinalysis 
Cx
Membranes 
Colour of liquor
Meconium
23
Q

What is the passing of meconium associated with?

A

Foetal distress and poor prognosis

24
Q

What are the phases of the second stage of labour?

A

Passive

Active

25
Q

What is the passive phase of the second stage of labour?

A

Where patient is fully dilated but waiting for powerful contractions to cause the baby to descend through pelvis and vagina, can carry on for as long as needed

26
Q

What is the active phase of the second stage of labour?

A

Delivery by extension
Restitution and external rotation
Expulsion and delivery of shoulders

27
Q

What prolongs the second stage of delivery and when is this not good?

A

Use of epidural anaesthesia

Not good in CV patients

28
Q

What is involved in the third stage of labour?

A

The separation of the placenta, its descent to the lower segment and its expulsion with the membranes
Gush of blood, cord lengthening, rising fundus
Controlled cord clamping
(physiological or active)