Flashcards in Care of 2nd stage labour Deck (20)
What are the aims for providing care?
protecting and promoting physiological processes
positive experiences for mother
detecting deviation from normal and referral when needed.
What are the principles of care in the 2nd stage?
labour is progressing
What are the maternal observation in 2nd stage labour?
Timing contractions every 30 minutes for 10 minutes
Continue; temp, Pulse, Blood pressure, respiration rate
verbal and non verbal communication
Wha are the fetal observations in 2nd stage labour?
fetal heart rare every 5 minutes following a contraction
What do you do if no obvious signs of progressing labour?
decent, rotation and flexion of the presenting part by performing a VE as per guideline consent
What are the observations for second stage labour?
temp 4 hourly
pulse every 15 min
abdominal palpation to access decent and progress
assess per vaginum discharge
encourage regular bladder emptying
What is the passive stage of stage 2?
full dilation of the cervix in the absence on involuntary explosive contractions
What is the active stage of stage 2 labour?
the baby is visible, expulsive contractions with a finding a full dilatation of other signs of full dilatation
What is the definition of second stage delay in nulliparous women?
progress of decent of the presenting part is inadequate after 1 hour of active second stage
What is the definition of delay of second stage labour delay in multiparous wmone?
progress of descent of the presenting part is inadequate after 30 minutes of active second stage
What is the semi- recumbent position?
supported sitting, most common reduces pelvic outlet
describe left lateral position
if unable to abduct their hips, or if epidural in use
describe upright positions
squatting, kneeling, all fours, standing, using birthing ball
reduces second stage, fewer assisted births, fewer episiotomies, reduced pain in 2nd stage
describe lying flat on your back
increased risk of hypertension, reduce placental perfusion and fetal oxygenation, reduced uterine contractions
describe the birth of the head
covering anus with clean pad
unhurried active phase to safeguard the perineum
once the head has crowned, gently blowing with contractions to minimise active pushing
Why do you not check for the chord when the head is born?
causes maternal discomfort distraction: would cause delayed contraction
stopping blood flow to the baby
What can you do to untangle to the chord front eh babies neck?
the somersault manoeuvre
What do you do with the birth of the shoulder?
hands on the baby's head covering ears
Gentle downward tracking to assist the birth of anterior shoulder
Oxytocic agent if active management is the choice
gentle upward traction to deliver posterior shoulder
time of birth is noted and recorded
What do you do immediately after the birth?
start skin to skin
keep mother and baby warm
Facilitate breastfeeding within the first hour