28/01/2025 20:58:15
Obstetrics 2
what is the presentation of a fetus?
which parts presents to pelvis 1rst e.g cephalic or breech
What is the lie of the fetus?
the orientation of fetal spine relative to maternal spine usually longitudinal (parallel)
what is the position of the fetus?
How the presenting part is situated in the pelvis rotationally
what is the station of the fetus?
position of bi-parietal diameter relative to ischail spins 0= at level of ischail spines
(how far t has descended into pelvis)
what is the attitude of a baby?
the degree of flexion of the head as this will determine the diameter that passes
through the pelvis completely flexed is the smallest so the easet to pass , whereas
the brow position is much more difficult to pass
how can you differentiate between brown and face attitude of fetus?
brow you feel frontal fontanelle eye and nose
face you feel chin mouth as well and frontal fontanelle to lesser extent
what are the mechanistic stages of labour?
Engagement of the head into the pelvis
descent and flexion of the head
internal rotation
extension a the head exits the pelvis
restitution ( as the head passes out of the pelvis so its inline with the spine)
Delivery of shoulders
, 28/01/2025 20:58:15
what are the main signs that labour is starting?
the starting of regular painful contractions that occur every 3-4 minutes with
increasing intensity
+- rupture of membranes
+_ show passing of cervical mucous plug
false labour
women undergoes contractions that are irregular and variable intensity with no
cervical effacement
what are the 3 broad mechanical factors that determine whether labour is going to be
successful?
Powers (contraction of uterus enough to expel baby most common problem in
nulliparous women)
Passage ( is the pelvis large enough rarely may be tooo small in some women may
have pelvic abnormalities)
Passenger (abnormal head position can make birth uch more dificult
how long is a typical birth in nulliparous women?
normally less than 8 hours total but up to 18 is within normal range
how long is a typical birth in multiparous women?
2nd birth should be under 5 hours but up to 12 is normal
what examinations should be done on a women that is presenting seemingly in
labour?
BOP, urinalysis, pulse , vgianl examination
what is the 1rst stage of labour?
from start of dilation to full dilation
latent 1rst stage of labour?
this is from the start of dilation to 3cm dilation, it is a slow phase before contractions
are established and can take days
Active 1rst stage of labour?
3vm-10cm dilation should progress at least a rate of 0.5cm/hour
what monitoring is done in the 1rst stage of labour?
half hourly measurement of contractions
4houlry measurement of , temperature , pulse and urine
when should C-section be considered in prolonged active 1rst stage?
if active 1rst stage last more than 12-16 hours
What is the 2nd stage of labor?
from full dilation to expulsion of the fetus
how long typically is the 2nd stage in nulliparous birth?
3 hours
how long typically is the 2nd stage in multiparous birth?
2 hours
What areare the 2 parts of the 2nd stage of labour?
1=passive descent wheere the fetal head descended without the active urge to push
active phase active desire to push and bare down form mother
Obstetrics 2
what is the presentation of a fetus?
which parts presents to pelvis 1rst e.g cephalic or breech
What is the lie of the fetus?
the orientation of fetal spine relative to maternal spine usually longitudinal (parallel)
what is the position of the fetus?
How the presenting part is situated in the pelvis rotationally
what is the station of the fetus?
position of bi-parietal diameter relative to ischail spins 0= at level of ischail spines
(how far t has descended into pelvis)
what is the attitude of a baby?
the degree of flexion of the head as this will determine the diameter that passes
through the pelvis completely flexed is the smallest so the easet to pass , whereas
the brow position is much more difficult to pass
how can you differentiate between brown and face attitude of fetus?
brow you feel frontal fontanelle eye and nose
face you feel chin mouth as well and frontal fontanelle to lesser extent
what are the mechanistic stages of labour?
Engagement of the head into the pelvis
descent and flexion of the head
internal rotation
extension a the head exits the pelvis
restitution ( as the head passes out of the pelvis so its inline with the spine)
Delivery of shoulders
, 28/01/2025 20:58:15
what are the main signs that labour is starting?
the starting of regular painful contractions that occur every 3-4 minutes with
increasing intensity
+- rupture of membranes
+_ show passing of cervical mucous plug
false labour
women undergoes contractions that are irregular and variable intensity with no
cervical effacement
what are the 3 broad mechanical factors that determine whether labour is going to be
successful?
Powers (contraction of uterus enough to expel baby most common problem in
nulliparous women)
Passage ( is the pelvis large enough rarely may be tooo small in some women may
have pelvic abnormalities)
Passenger (abnormal head position can make birth uch more dificult
how long is a typical birth in nulliparous women?
normally less than 8 hours total but up to 18 is within normal range
how long is a typical birth in multiparous women?
2nd birth should be under 5 hours but up to 12 is normal
what examinations should be done on a women that is presenting seemingly in
labour?
BOP, urinalysis, pulse , vgianl examination
what is the 1rst stage of labour?
from start of dilation to full dilation
latent 1rst stage of labour?
this is from the start of dilation to 3cm dilation, it is a slow phase before contractions
are established and can take days
Active 1rst stage of labour?
3vm-10cm dilation should progress at least a rate of 0.5cm/hour
what monitoring is done in the 1rst stage of labour?
half hourly measurement of contractions
4houlry measurement of , temperature , pulse and urine
when should C-section be considered in prolonged active 1rst stage?
if active 1rst stage last more than 12-16 hours
What is the 2nd stage of labor?
from full dilation to expulsion of the fetus
how long typically is the 2nd stage in nulliparous birth?
3 hours
how long typically is the 2nd stage in multiparous birth?
2 hours
What areare the 2 parts of the 2nd stage of labour?
1=passive descent wheere the fetal head descended without the active urge to push
active phase active desire to push and bare down form mother
