What is labor?
Labor is the process of uterine contractions that bring about changes in the cervix, resulting in the spontaneous expulsion of a mature fetus, followed by the expulsion of the placenta and membranes.
What are the stages of labor?
First stage: Latent phase, Active phase, and Transition phase. Second stage: Delivery of the fetus. Third stage: Delivery of placenta and membranes. Fourth stage: Observation stage.
What is the first stage of labor?
The first stage begins with the onset of true uterine contractions and ends when the cervix is fully dilated (10 cm).
What is the duration of the first stage of labor for primigravida and multigravida?
Primigravida: 8-12 hours. Multigravida: 6-8 hours
What are the phases of the first stage of labor?
Latent phase: Slow dilation of the cervix up to about 3 cm. Active phase: Rapid dilation from 3 cm to 10 cm.
What happens during the second stage of labor?
It is the period from full cervical dilation (10 cm) to the birth of the fetus. The fetus descends through the birth canal and is delivered.
What is the duration of the second stage of labor for a primigravida and multigravida?
Primigravida: 1 hour. Multigravida: 30 minutes.
What happens during the third stage of labor?
It is the period after the birth of the fetus, during which the placenta and membranes are delivered. It usually lasts up to 30 minutes.
What are the signs of placental separation in the third stage of labor?
Gush of blood, Lengthening of the umbilical cord, The uterus becoming globular and hard.
What is active management of the third stage of labor (AMTSL)?
AMTSL includes uterotonic administration, controlled cord traction, and uterine massage to prevent postpartum hemorrhage.
What is the fourth stage of labor?
It lasts 1-4 hours after birth and involves recovery for both the mother and newborn. Vital signs are closely monitored to detect any complications like postpartum hemorrhage.
What distinguishes true labor from false labor?
True labor: Contractions are regular, increase in intensity, cause cervical dilation. False labor: Contractions are irregular, do not cause cervical dilation, and are relieved by sedation.
What hormonal changes initiate labor?
The fetal brain releases CRH, stimulating the pituitary to release ACTH. This leads to the release of cortisol and DHEA-S, which increase estrogen and prostaglandins, initiating labor by making the cervix soft and sensitive to oxytocin.
What maternal factors contribute to the initiation of labor?
Hormones like progesterone, estrogen, oxytocin, and prostaglandins, along with psychological factors.
How does fetal cortisol affect the initiation of labor?
Fetal cortisol increases estrogen production in the placenta, which enhances uterine sensitivity to oxytocin, leading to uterine contractions.
What is cervical effacement?
Effacement refers to the thinning of the cervix during labor as it prepares for dilation.
What is the difference between cervical effacement and dilation?
Effacement is the thinning of the cervix, while dilation is the opening of the cervix.
What are the seven cardinal movements of labor?
- Engagement 2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. External rotation (restitution) 7. Delivery of the shoulder and fetal body
When is an episiotomy performed?
An episiotomy is performed during crowning to prevent extensive perineal tears.
What are the four degrees of perineal tears?
- First degree: Mucosa and skin. 2. Second degree: Mucosa, skin, and muscle. 3. Third degree: Mucosa, skin, muscle, and anal sphincter. 4. Fourth degree: Mucosa, skin, muscle, anal sphincter, and rectal mucosa.
What is retained placenta, and how is it managed?
Retained placenta is when the placenta does not deliver within 30 minutes of fetal birth. Management includes manual removal or surgical intervention.
What are the complications of improperly managing the third stage of labor?
Complications include postpartum hemorrhage, uterine inversion, and retained placenta.
What is a partograph?
A partograph is a graphical tool used to monitor and document the progress of labor, including cervical dilation, fetal descent, and contractions.
Why is the partograph important in labor management?
It helps to identify abnormalities in labor progression and decide when interventions are necessary.
