Normal Labour and Puerperium Flashcards

(44 cards)

1
Q

Labour deifnition?

A

Process whereby products of conception are expelled from uterine cavity after 24th week of gestation

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2
Q

Braxton hicks is what?

A

Tightening of uterine muscles thought to help body prepare for birth

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3
Q

When can Braxton Hicks happen?

A

6 weeks into pregnancy but usually 3rd trimester
Irregular
Resolve with ambulation or activity change

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4
Q

Onset of labour involves what?

A

Progesterone withdrawal and increase in oestrogen and prostaglandin action

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5
Q

Clinical signs of labour onset?

A

Regular, painful contractions which increase in frequency and duration and that produce progressive cervical dilatation

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6
Q

Rupture of membranes known as?

A

Water breaking

Although onset is variable and may occur without uterine contractions

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7
Q

If period between ROM and oainful uterine conractions is greater than 4 hours it is called?

A

Pre labour rupture of membranes (PROM)

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8
Q

how many stages of labour?

A

3

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9
Q

First stage of labour?

A

Onset of regular painful contractions and cervical changes until it reaches full dilatation and cervix is no longer palpable

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10
Q

Second stage of labour?

A

Duration from full cervical dilation to delivery of foetus
-Subdivided into pelvic or passive phase when head descends in the pelvis
and
-Active or perineal phase when mother gets stronger urge to push and foetus is delivered with force of uterine contractions and maternal bearing down effort

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11
Q

Third stage of labour?

A

Duration from delivery of newborn to delivery of placenta and membranes

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12
Q

What influences progression of 2nd stage of labour?

A

3 key factors (3 Ps)

1) Power
2) Passage
3) Passenger

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13
Q

What shape of pelvis is best for child birth?

A

Gynaecoid pelvis but some women have anthropoid or android

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14
Q

7 cardinal movements of labour?

A
Engagement 
Descent 
Flexion 
Internal Rotation 
Extension 
External rotation 
Expulsion
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15
Q

What is engagement?

A

Passage of widest diameter of presenting part to a level below plane of the pelvic inlet, described in terms of station which refers to level of presenting part above or below mums ischial spine in CM

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16
Q

Descent?

A

Downward movement of presenting part through pelvis

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17
Q

Flexion?

A

Flexion of foetal head occurs passively as head descends due to shape of bony pelvis and resistance offered by soft tissues

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18
Q

Internal rotation?

A

Rotation of presenting part from its original position to the anterior position as it passes through pelvis

19
Q

Extension?

A

Occurs once foetus has reached the introitus and base of occiput is in contact to inferior margin of the pubic symphysis

20
Q

External rotation?

A

Return of foetal head to correct anatomical position in relation to foetal torso and shoulders

21
Q

Expulsion?

A

Delivery of rest of foetal body

22
Q

Entering the pelvis the foetus should be lying?

23
Q

What is corwning?

A

Refers to appearance of large segment of foetal head at introitus- at this point labia are stretched to full capacity and largest diameter of foetal head is encircled by Vulval ring

24
Q

What stage of labour does crowning occur in?

25
In 3rd stage of labour uterus ____, _______ and _______?
Contracts Hardens Rises
26
Whole process of 3rd stage of labour lasts?
5-10 minutes
27
Diagnosis of retained placenta menas?
Placenta is not expelled within 30mins or 60 mins if no active management
28
What does active management of 3rd stage of labour invovle?
Uterotonic drugs | Ergometrine maleate or oxytocin, cord clamping and cutting and bladder catheterization
29
What does active management prevent?
XS bleeding
30
Blood loss of less than _______ is normal in this stage of labour?
500mls
31
What is puerperium?
Postpartum period from birth of baby through to involution of uterus at 6 weeks -Period of recovery and repair
32
If lactation continues what happens to menstruation?
May be deferred for longer than 6 weeks
33
Discharge from uterus term and character in days 2-14?
Fresh or altered blood | Lochia Rubia
34
Lochia serosa is?
Brownish discharge
35
Slight white discharge is called?
Lochia alba
36
Persistence of lochia rubia may imply?
Presence of retained placental tissue or foetal membranes
37
Hormones which influence labour onset?
Progesterone Oestrogen Oxytocin
38
What is progesterones role?
Keeps uterus settled | -Prevents formation of gap junctions
39
Oestrogens function?
Makes uterus contract
40
Oxytocin function?
Initiates and sustains contractions
41
Bishop score tells us what?
If it is safe to induce labour
42
Bishops score of 4 or less?
Indicates unfavourable cervix and requires opening
43
Summary of second stage of labour?
Full dilation- delivery of baby
44
What happens if cord is immediately clamped?
Reduce RBCs, potentia short term and long term neonatal problems