Module 6 -Labour and Delivery

Regular, patterned uterine fundal contractions, progressive effacement and dilation of cervical, loss of mucus plug, rupture of membranes

Define labour

Bloody show

What is another term for the loss of the mucus plug

Water broke

What is another term for the rupture of membranes

Not effaced or dilated

Describe the cervix in this image

Cervix effaced and not dilated

Describe the cervix in this image

Cervix fully effaced and starting to dilate

Describe the cervix in this image

3

How many stages of labour are there

Progressive cervical effacement and dilatation, descent of fetus, regular contractions

What is the first stage of labour

12-24 hours

How long does the first stage of labour usually last

1cm/hr

What is the normal progression of cervical dilatation

2nd stage

What stage of labour does delivery occur in

True

T/F: the cervix is fully dilated in stage 2 of labour

50mins

What is the average duration in the second stage of labour in the primigravida patient

20mins

What is the average duration in the second stage of labour in the multiparous patient

Birth to expulsion of placenta

What is the third stage of labour

10 mins

What is the usual duration of the third stage of labour

Oxytocin

What hormone is released in the third stage of labour

Cephalic/vertex

what is the most common position of a fetus?

4%

What is the percentage of babies in the breech presentation

Small baby, can move around easier

What may increase the risk of the baby being in the breech position

Difficult birth

Define dystocia

Failure to progress, cervix not changing with contractions

Describe dystocia

Oxytocin through IV

How are patient with dystocia treated

Disproportion of the fetal head to the maternal pelvis, mass obstructing way, abnormal position

What are some things that may cause dystocia

Fetal head too big or maternal pelvis too small

Explain an examples of the fetal head being disproportional

Fibroids in canal

Give an example of a mass causing dystocia

Painless bleeding

What is placenta previa

Painful bleeding

What is abruption of the placenta

Induced labour

What is PROM

Placenta previa is painless and abruption is painful

What is the difference between placenta previa and the abruption of the placenta

Mild placenta abruption, IUGR, post dates, amnionitis, PROM, maternal disease, fetal death, hx of quick delivery but great distance from hospital

List 8 reasons for the induction of labour

After 40 week gestation

What post date may indicate induction of labour

Pre-eclampsia, diabetes

What are two maternal disease that may indicate the induction of labour

Black tarry substance in the neonate's first bowel movement

What is meconium

After birth

When should the meconium occur

If meconium occurs in utero

When can meconium aspiration occur

Distress

What may cause a fetus to have the meconium in utero

Lung infection

What is the main concern when aspiration of the meconium occurs

Footling/incomplete breech, prolonged membrane rupture and not uterine contractions, fetal distress, dystocia, >4kg weight, small maternal pelvic, social reasons

What are 7 reasons for a cesarean section

L/S ratio, non stress test, fetal scalp blood gases

What are some diagnostic test associated with labour and deliver

2:1

What L/S ratio indicates that fetal lungs are mature

If the fetus is monitored with contractions

When does a non stress test become a stress test

Fetal monitor

What is a non stress test

Done during labour to determine if fetus is getting enough oxygen, and determine is c-section is needed

What is a fetal scan blood gases test