Please enable JavaScript.
Coggle requires JavaScript to display documents.
OBS 1 labour (definition (post-term (> 42 weeks), post date (40-42…
OBS 1 labour
definition
post-term (> 42 weeks)
post date
(40-42 weeks)
term
(37-42 weeks)
preterm
(viable 24-<37 weeks)
EDC expected date of confinement
(normal conception, v LMP: LMP + 40 weeks)
(normal conception, x LMP: crown-rump length)
(ovulation induction: put date on (2 weeks)
(intrauterine insemination: put date on (2 weeks)
(fresh embryo transfer: put date on (2 weeks)
(frozen embryo transfer: put date on (2 weeks + 5 days)
LMP
gestation: since LMP
(40 weeks, 280 days)
cardiotocogram
fetal heart rate did not return to normal spontaneously
prolonged deceleration from 140 to 70 bpm since (??:??) to (??:??)
1 basal heart rate, 2 normal variability, 3 any acceleration/deceleration
uterine contraction (?) per 10 minutes
This is a CTG of Ms. (?), taken from (??:??) to (??:??), 1 cm/minute
labour
TRUE/FALSE LABOUR
external tocography/palpation
(regular, painful: uterine contractions)
(1st back, 2nd abdomen)
(progressively high frequency, longer duration)
TRUE/FALSE LABOUR
vaginal examination
(progressive cervical effacement and dilation)
cervix thinning/cervix opening 0-10 cm
show (and/or rupture of membrane)
(blood-tinged mucus)
successful
power (uterine muscles: frequency, amplitude, duration)
passengers (SIZE, number, lie, presentation...)
passage (pelvis)
placenta (previa)
physiology (body systems)
stages of labour
third stage
(delivery of infant - delivery of placenta)
second stage
(full cervical dilation - delivery of infant)
first stage
(onset of labour - full cervical dilation)
latent phase (0-2 cm cervical dilation)
active phase (3-10 cervical dilation & full cervical effacement)
nulliparous: 1.2 cm/hr
multiparous: 1.5 cm/hr
uterine contraction
normal: less than or equal to 5 in 10 minutes
tachysystole: more than 5 in 10 minutes
uterine hypertonus: more than 2 minutes
(uterune hyperstimulation: tachysystole or uterine hypertonus)
induction of labour
Bishop score
1 dilation 2 length/effacemenr? 3 level/station
4 consistency(firm/average/soft) 5 position (post/mid&ant)
methods
(unfavourable cervix) Bishop <6
prostaglindin E2 (vaginal pessary
1st morning: 20-minute CTG: reactive & 20-minute CTG 1 he later, 2nd six hours, 3rd next morning)
(favourable cervix) Bishop 6
amniotomy (amnion hook)
+/- syntocinon (IV: titrate: optimal 3-4 in 10 min)
others
(membrane sweeping)
(cervical ripening balloon)
onset of labour
spontaneous onset
(+/- augmentation)
amniotomy (amnion hook)
syntocinon (IV: titrate: optimal 3-4 in 10 min)
cord prolapse
uterine rupture
uterine hyperstimualation
failed induction of labour
induction of labour
indications
(history of rapid labour) (HT/PET, DM, PPROM) MOTHER
(IUGR at 37 weeks, polyhydramnios at 38 weeks, PPROM) (post-date) (intrauterine death, lethal abnormalities: anencephaly, Edward, Patau) BABY
contraindictons
(aug & induc)
fetal distress, cephalo-pelvic disproportion, major placenta previa
labour progress
head palpable/descent
cervical dilation
latent phase 0-2 cm
prolonged latent phase
(nulliparous: more than 20 hours)
(multiparity: more than 14 hours)
false labour
sedatives
suboptimal uterine contractions
cephalo-pelvic disproportion
amniotomy (amnion hook)
sybtocinon (IV: titrate)
active phase 3-10 cm
secondary arrest
(2 hours withiur cervical change
(despite good uterine contractions
suboptimal uterine contractions
cephalo-pelvic disproportion
malposition of fetus
amniotomy (amnion hook)
sybtocinon (IV: titrate)
partogram
demographics, maternal, fetal, labour progress, medications
mechanism of labour (LOA)
1 engagament 2 descent 3 internal rotation
4 crowning 5 extension 6 restitution
7 internal rotation of shoulders 8 external rotation of head 9 laternal flexion
liquor, moulding, caput
induction of labour
maternal
uterine rupture
failure of induction high chance of Caesarean section
fetal
fetal distress
intrauterine infection
favorable means proceed to induction of labour