Childbirth

Question 1

what is the role of oxytocin and prostaglandins in childbirth?

Answer 1

Prostaglandins (misoprostol - PGE1) used to soften cervix and begin dilation of the cervix.

Oxytocin: causes uterine contractions + clotting of uterine vessels. Given after the 2nd stage of labor to manage the third stage of labor

Question 2

What are the stages of labor?

Answer 2

1st stage - beginning of contractions until the cervix is fully dilated.

2nd stage - descent and birth of the baby

3rd stage - placental expulsion.

4th stage - first 2 hours after birth (breast feeding, tear repair, monitoring: vital signs, constancy of fundus, blood loss assessment).

Question 3

What are the 8 stages of the baby’s descent?

Answer 3

1. Engagement - widest portion of the presenting part has passed through the pelvic inlet.
2. Descent - through the brim to the mid pelvis. Aided by uterine contractions.
3. Flexion - head flexes (tucks) as it passes into the mid-pelvis. Occiput pushes on the llevator ani muscle (gutter)
4. Internal rotation - 90degree rotation of the head: sagittal suture lies in AP line (widest section at outlet)
5. Extension - extension of the head so occiput no longer trapped under pubic symphysis (crowning)
6. Restitution - head realigns with shoulders (oblique)
7. External rotation - shoulders rotate so they are aligned with AP angle (widest at brim)
8. Delivery of shoulders and fetal body. Anterior shoulders delivered 1st.

Question 4

What are the 3 factors that affect the outcome of labor?

Answer 4

1. Power - uterine contractions.
2. Passenger -
3. Pelvis -