Normal Labour and its Management

Question 1

Is Progesterone a retention factor or a releasing factor for Labour? How does it work?

Answer 1

Retention factor

Dampens excitability of smooth muscle in uterus and strengthens the sphincter at the Internal Os

Question 2

Is being Hypervolaemic a state which helps retain a pregnancy, or release one? Why?

Answer 2

Retention factor
Inhibits hormones of the Posterior pituitary gland i.e. Oxytocin / Vasopression which therefore dampens uterine contractility

Question 3

Is Adrenaline a retention or a releasing factor for Labour? How does it work?

Answer 3

Retention factor

Blocks secretion of oxytocin

Question 4

Is Corticotropin Releasing Hormone (CRH) a retention or a releasing factor for Labour? How does it work?

Answer 4

Retention factor

Prevents labour onset by inhibiting Prostaglandin production.

Question 5

Is Oestrogen a retention or a releasing factor for Labour? How does it work?

Answer 5

Releasing factor

Increases the sensitivity of the uterine muscle to oxytocin

Question 6

Is Oxytocin a retention or a releasing factor for Labour? How does it work?

Answer 6

Releasing factor

Increases uterine contractions, as there are specific receptors in the myometrium

Question 7

Is Cortisol a retention or a releasing factor for Labour? How does it work?

Answer 7

Releasing factor

Decreases progesterone secretion

Question 8

Are Prostaglandins a retention or a releasing factor for Labour? How does it work?

Answer 8

Releasing factor

Increases myometrial contractility, and relaxes the cervical sphincter

Question 9

What are the four types of Pelvises?

Answer 9

• Gynecoid
• Android
• Anthropoid
• Platypelloid

Question 10

What is the most favourable Pelvis type for the mechanism of Labour? Why?

Answer 10

Gynecoid, narrow pubic arch and short ischial spine

Question 11

All uteri have some degree of resting tone - what is it?

Answer 11

2 to 10mmHg

Question 12

What is the name of the two fontanelles in a foetal skull?

Answer 12

Anterior fontanelle

Posterior fontanelle

Question 13

Which of the fontalles appear “diamond” shaped?

Answer 13

Anterior fontanelle

Question 14

At what stage of a pregnancy does a baby engage with the pelvis?

Answer 14

36 weeks

Question 15

What are the 7 Cardinal movements of Labour?

Answer 15

1. Engagement
2. Descent
3. Flexion
4. Internal Rotation
5. Extension
6. External Rotation
7. Expulsion

Question 16

State the four stages of Labour

Answer 16

1. Latent phase
2. First stage
3. Second stage (active and passive)
4. Third stage

Question 17

At what stage of labour does the birth of a child occur?

Answer 17

Active sub-stage of the second stage

Question 18

What occurs in the Third stage of labour?

Answer 18

Delivery of the placenta and membranes, contraction, and haemostasis

Question 19

In the first stage of labour, what occurs?

Answer 19

Onset of regular contractions, 3-4cm to 10cm dilation

Question 20

When should a birth plan be made and evaluated with a midwife?

Answer 20

36 weeks

Question 21

Why might an Episiotomy occur?

Answer 21

To prevent a third degree tear into the anal sphincter

Question 22

What combination drug can be administered to induce uterine contractions to expel the placenta? What are the two individual drugs? When is it adminisitered?

Answer 22

Syntometrin (Oxytocin + Ergometrine)

Administered in the third stage of labour

Question 23

For labour, a woman should ideally progress by how many cm per hour?

Answer 23

1cm per hour

Question 24

What is Entenox pain relief?

Answer 24

50% oxygen, 50% Nitrous Oxide