Notes in 3. Labour

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Published	02/10/2024	The {{c1::first}} stage of labour is from {{c2::the onset of labour (true contractions)}} until {{c2::10cm cervical dilatation}}.
Published	02/10/2024	The first stage of labour involves two processes:{{c1::cervical dilation}} and {{c1::effacement (getting thinner from front to back)}}
Published	02/10/2024	Suboptimal Progress in the first stage of labour: Cervical dilation {{c1::<0.5}} cm per hour for {{c2::primigravid}} women (first time) Cervical di…
Published	02/10/2024	If uterine contractions are inadequate then the foetal head will not descend and exert force on the cervix, and the cervix will not {{c1::dilate}}.
Published	02/10/2024	The strength and duration of uterine contractions can be increased by giving {{c1::IV oxytocin e.g. synotocinon}} (Augmented Labour)
Published	02/10/2024	IMPORTANT: Exclude an {{c2::obstructed}} labour prior to giving IV oxytocin to avoid resulting in a {{c1::ruptured uterus}}
Published	02/10/2024	The {{c1::second}} stage of labour is from {{c2::10cm cervical dilatation}} to {{c2::delivery of the baby}}.
Published	02/10/2024	The three P’s used to describe normal labour and possible complications: {{c1::Power}}, {{c1::Passenger}}, {{c1::Passage}}
Published	02/10/2024	Power describes the {{c1::strength of the uterine contractions}}
Published	02/10/2024	Passenger involves four descriptive qualities of the fetus: {{c1::Size}}, {{c1::Attitude}}, {{c1::Lie}}, {{c1::Presentation}}
Published	02/10/2024	The Ideal foetal position is a {{c1::Longitudinal}} lie with a {{c1::Vertex}} presentation
Published	02/10/2024	The Four Qualities of a PassengerSize: The most important is the size of the {{c1::head}} as this is the largest part.
Published	02/10/2024	The Four Qualities of a PassengerAttitude: describes the {{c1::posture}} of the fetus. For example, how the back is rounded and how the head and limbs…
Published	02/10/2024	The Four Qualities of a PassengerLie: describes the {{c1::position of the fetus in relation to the mother’s body}}Three Types: ({{c2::Longitudina…
Published	02/10/2024	The Four Qualities of a PassengerPresentation: describes the {{c1::part of the fetus closest to the cervix}} Three Types: ({{c2::Cephalic}}, {{c2::Sho…
Published	02/10/2024	The {{c1::third}} stage of labour is from {{c2::delivery of the baby}} to {{c2::delivery of the placenta}}
Published	02/10/2024	Role of Prostaglandins in Menstruation and Labour is {{c1::stimulating the contraction of the uterine muscles}} and {{c1::ripening the cervix prior to…
Published	02/10/2024	{{c1::Induction of Labour}} is when labour is artificially induced using medications or devices to:[1] {{c2::Ripen the cervix}}[2] {{c2::Rupture membr…
Published	02/10/2024	Induction of Labour is a high risk procedure so it requires {{c1::Cardiotocogtaphy (CTG)}} monitoring of the fetus
Published	02/10/2024	Pharmacological Ripening of the Cervix is via usage of {{c1::Prostaglandins e.g. misoprostol}}
Published	02/10/2024	Mechanical Ripening of the Cervix is via usage of {{c1::Balloon}}
Published	02/10/2024	The higher the {{c1::Bishop's}} score, the more progressive change there is in the cervix and indicates that induction is likely to be successful
Published	02/10/2024	A {{c2::Bishop’s}} score of >{{c1::7}} is favourable for amniotomy
Published	02/10/2024	{{c1::Amniotomy}} is {{c2::artifically rupturing the foetal membrane ‘’breaking water’’ using a sharp device}}
Published	02/10/2024	During Induction of Labour, once amniotomy is performed, {{c1::IV oxytocin e.g. synotocinon}} can be given to achieve adequate contractions *unless th…
Published	02/10/2024	During Induction of Labour, if IV oxytocin is given, the amount of contractions aimed for is {{c1::4-5}} in {{c1::10}} mins
Published	02/10/2024	Indications for Induction of Labour {{c1::Diabetes}} {{c1::Post-Date — Term + 7 Days (e.g. over 41 weeks)}} {{c1::Maternal Reason (on treatment for DV…
Published	02/10/2024	Power-Related Inadequate Labour Progression may be due to {{c1::inadequate uterine activity}}
Published	02/10/2024	Passage-Related Inadequate Labour Progression may be due to:[1] {{c1::Cephalopelvic disproportion (CPD)}}[2] {{c1::Obstruction}}
Published	02/10/2024	{{c1::Cephalopelvic disproportion (CPD)}} is a {{c2::mismatch of foetal head and mother’s pelvis}}
Published	02/10/2024	Signs of {{c2::Cephalopelvic disproportion (CPD)}} is development of {{c1::caput (soft tissue swelling)}} and {{c1::moulding (foetal skull bones cross…
Published	02/10/2024	Inadequate Labour Progression secondary to Obstruction due to:[1] {{c1::Fibroids}}[2] {{c1::Hydrocephalus}}[3] {{c1::Placenta praevia (Placenta below …
Published	02/10/2024	Passenger-Related Inadequate Labour Progression may be due to[1] {{c1::Malposition}}[2] {{c1::Malpresentation}}
Published	02/10/2024	Inadequate Labour Progression secondary to Malposition due to:foetal head being in a suboptimal position for labour leading to a relative {{c1::C…
Published	02/10/2024	Position is determined by feeling the baby’s posterior and anterior {{c1::fontanelles}} during a vaginal examination to check where the {{c2::occiput}…
Published	02/10/2024	Inadequate Labour Progression secondary to Malpresentation due to:[1] {{c1::Breech}} presentation[2] {{c1::Shoulder}} presentation[3] {{c1::Trans…
Published	02/10/2024	{{c1::Foetal Distress}} is a high risk presentation where the baby can be small, growth restricted, or preterm labour.
Published	02/10/2024	The main causes of Foetal Distress are {{c1::Hypoxia}} and {{c1::Sepsis (chorioamnionitis)}}
Published	02/10/2024	{{c1::Uterine Hyper-Stimulation}} describes {{c2::too many uterine contractions resulting in foetal distress due to insufficient placental blood flow}…
Published	02/10/2024	Cord prolapse and Placenta praevia need to be delivered immediately by {{c1::C section}}
Published	02/10/2024	Methods of Foetal Monitoring:[1] {{c1::Intermittent Auscultation ‒ low-risk labours}}[2] {{c1::Cardiotocography (CTG) ‒ high-risk labours}}[3]&nb…
Published	02/10/2024	In the {{c1::2nd}} stage of labour, the foetal's heart is listened to every {{c2::5 mins::Duration}}
Published	02/10/2024	{{c1::Cardiotocography (CTG)}} is a foetal monitoring method done for high risk labours where there is a continuous recording of the fetal heart …
Published	02/10/2024	Foetal Blood Sampling is done to measure {{c1::pH (Hypoxaemia)}} and {{c1::Lactic acid}}
Published	02/10/2024	Types of Operative Deliveries[1] {{c1::Instrumental Delivery (Forceps, Ventouse)}}[2] {{c1::Planned C-Section}}[3] {{c1::Emergency C-Se…
Published	02/10/2024	Third Stage of Labour Complications[1] {{c1::Retained placenta (Risk of PPH)}}[2] {{c1::Post Partum Haemorrhage (PPH)}}[3] {{c1::Tears}…
Published	02/10/2024	The 4 T's of Post Partum Haemorrhage are {{c1::Trauma}}, {{c1::Tone}}, {{c1::Thrombin}}, {{c1::Tissue}}
Published	02/10/2024	Types of Tears possible during Third Stage of Labour{{c1::}}
Published	02/10/2024	{{c1::IV fluids}} are given alongside {{c2::IV oxytocin}} due to risk of {{c3::hypotension}} and {{c3::hyponatraemia}}
Published	02/10/2024	A Bishop's score of less than {{c1::5}} indicates a low successful rate of Induction of Labour, so a {{c2::vaginal prostaglandin}} or an {{c2::intrace…
Published	02/10/2024	A method of foetal monitoring during low-risk labours is via {{c1::intermittent auscultation}} using doppler ultrasound
Published	02/10/2024	Foetal blood sampling is done to confirm CTG signs of foetal {{c1::hypoxia}}
Published	02/10/2024	If the result of Foetal Blood Sampling show pH {{c1::<7.20}} then {{c2::immediate delivery}} is indicated
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