Labour

Question 1

Stage 1 of labour

Answer 1

stage 1: from the onset of true labour to when the cervix is fully dilated

Question 2

Stage 2 of labour

Answer 2

stage 2: from full dilation to delivery of the fetus

Question 3

Stage 3 of labour

Answer 3

stage 3: from delivery of fetus to when the placenta and membranes have been completely delivered

Question 4

Stage 2

Answer 4

Stage 2 - from full dilation to delivery of the fetus
‘passive second stage’ refers to the 2nd stage but in the absence of pushing (normal)
active second stage’ refers to the active process of maternal pushing
less painful than 1st (pushing masks pain)
lasts approximately 1 hours
if longer than 1 hour (can be left longer if epidural) consider Ventouse extraction, forceps delivery or caesarean section
episiotomy may be necessary following crowning
associated with transient fetal bradycardia

Question 5

Bishop’s score

Answer 5

Cervical position
Cervical consistency
Cervical effacement
Cervical dilatation
Fetal station

Question 6

Methods of inducing labour

Answer 6

if the Bishop score is ≤ 6
vaginal prostaglandins or oral misoprostol
mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean
if the Bishop score is > 6
amniotomy and an intravenous oxytocin infusion

Question 7

Indication for induction of labour

Answer 7

• prolonged pregnancy, e.g. 1-2 weeks after the estimated date of delivery
• prelabour premature rupture of the membranes, where labour does not start
• maternal medical problems
  diabetic mother > 38 weeks
  pre-eclampsia
  obstetric cholestasis
• intrauterine fetal death