Normal birth & the puerperium Flashcards Preview

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Flashcards in Normal birth & the puerperium Deck (13)
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What is a normal birth

-No drugs used for induction
-Low- risk at the start of labour and remaining so throughout labour & delivery
-The infant is born spontaneously in the vertex position between 37& 42 weeks of pregnancy
-After birth mother & infant are in good condition


What are the characteristics of the early labour stage?

-Irregular contractions
-Bloody mucus show
-Rupture of membranes
-There is some cervical change, including cervical effacement & dilatation up to 4cms
-A period of time, not necessary continuous, when there are painful contractions


What are the characteristics of the active first labour stage?

-There are regular painful contractions and progressive cervical dilation from 4cm
-Progress usually considered normal if cervix dilates at least 0.5cm/hour


How do we monitor labour?

-vital signs
-urine output
-PV loss: liquor, blood
-emotional state
-Fetal heart activity


How is pain relief provided in labour

-breathing and relaxation


What are the characteristics relating to transition into the 2nd stage of pregnancy

-uncontrollable urge to push
-holding breath/ grunting
-mood changes ( sleepy/more focused)
-external genitals or anus begin to bulge out during contractions
-woman may feel the baby's head begin to move into the vagina
-A purple line between the mother's buttocks as they spread apart from the pressure of the baby's head


What are the characteristics of the 2nd stage of pregnancy?

1.) Passive 2nd stage:
-Full dilataation of the cervix prior to or in the absence of involuntary expulsive contractions
-The 'rest and be thankful stage'
-varies in length- usually around 1 hour
2.) Active 2nd stage: the baby is visible-expulsive contractions with a finding of full dilatation of the cervix or other signs of full dilatation
-Diagnosis of delay should be made for nulliparous women when it has lasted 2 hours and for parous women when it has lasted 1 hour


What are the characteristics of the 3rd stage of pregnancy?

-Comprises the phase of placental separation, its descent to the lower segment& its expulsion with the membrane
-The cord and placenta system will contain about 1/3 of baby's blood whilst the remaining 2/3 is in the baby
-After a few mins the cord will stop pulsating. The mother will often feel an urge to push shortly after this
-The contractions may be painful but the placenta usually slides out easily
-The midwife will check it to ensure that it's complete and none is left inside the mother
-Breastfeeding can stimulate a contraction and help the placenta separate from the womb


Describe the different types of management of the 3rd stage of pregnancy

-speeds up the delivery of the placenta
-Routine use of uterotonic drugs
-Deferred clamping and cutting of the cord
-Controlled cord traction after signs of separation of the placenta
-waiting for the placenta to come naturally, the mum pushes it out
-can take between 10mins to an hour
-No routine use of uterotonic drugs
-No clamping of the cord until pulsation has stopped
-delivery of the placenta by maternal effort


What is the puerperium?

-The time from the end of the 3rd stage through the first few weeks after delivery. This period is usually considered to be 6 weeks in duration


List some serious post partum complications and their signs/symptoms

Post partum haemorrhage:
-sudden and profuse blood loss
Pre eclampsia:
-Headaches accompanied by 1/more of the following symptoms within the 1st 72 hours after birth.. visual disturbances, nausea, vomiting
-unilateral calf pain
-abdominal pain and/or offensive vaginal loss


What is involution of the uterus

-Needs to be monitored during the puerperium
-Shrinkage& the body is sort of reabsorbing it all back


What is lochia

-Needs to be monitored during the puerperium
-Vaginal discharge after giving birth