LABOUR

Question 1

4 P’s of slow progress in labour

Answer 1

Power
passage
patient
passanger

Question 2

explain passage

Answer 2

• issue with soft tissues of birth canal (cervix, vagina, pelvic floor, perineum)
• CPD

Question 3

mechanisms of labour In Occipito-Anterior or Lateral Cases these are

Answer 3

In Occipito-Anterior or Lateral Cases these are:

1. Descent and further flexion of the head.
2. Internal rotation of head (to OA)
3. Extension and delivery of head
4. Restitution and external rotation
5. Delivery of anterior and posterior shoulder by lateral flexion
6. Delivery of trunk, buttocks and legs

Question 4

explain power component

Answer 4

adequate contractions = 3-4 strong contractions in 10 minutes.
Powers- Inadequate contractions (dysfunctional labour)
- poor dilatation, effacement, descent of the fetus
- Often inadequate contractions in primigravida
- establish stronger contactions by surgical or manual rupturing membranes and giving augmentaion with IV Oxytocin
- Reassess in 2hrs
- If no further progress deliver by c/s

Question 5

explain patient component

Answer 5

• Illness
• Full bladder
• Exhaustion
• Mobility
• Positioning
• Companion

Question 6

explain passenger component

Answer 6

• macrosomia
• Abnormal presentation or position
• Fetal abnormality e.g hydrocephalus

Question 7

signs of placenta separation

Answer 7

• PV bleeding
• A rise in the fundal height
• fundus becomes globular and firm
• lengthening of the umbilical cord
• traction upwards of the fundus fails to draw the cord with it

Question 8

mechanisms of labour

Answer 8

1. Descent and engagement
2. Flexion
3. Internal rotation
4. Crowning and extension
5. Restitution and external rotation
6. Lateral flexion: birth of the anterior shoulder followed by the posterior shoulder