Management of Normal Labour
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Questions and Answers

What is a key advantage of the active management of labor?

  • Higher load on medical staff
  • Less common prolonged labor (correct)
  • Increased maternal and fetal distress
  • Increased duration of labor

Which component is NOT part of active management of labor?

  • Care of the newborn
  • Antenatal education
  • Immediate delivery after rupture of membranes (correct)
  • Active management of the second stage

What is the primary aim of antenatal education in the context of labor management?

  • To prioritize medical intervention
  • To prepare the mother physically and emotionally (correct)
  • To increase anxiety about the birthing process
  • To discourage any pain management techniques

When examining a patient in the first stage of labor, which aspect is NOT assessed?

<p>Overall maternal physical appearance (A)</p> Signup and view all the answers

Which of the following is involved in the active management of labor during the second stage?

<p>Regularly monitoring uterine contractions (A)</p> Signup and view all the answers

What is the primary focus during the delivery of the fetal head to prevent perineal laceration?

<p>Supporting the perineum before crowning (D)</p> Signup and view all the answers

What technique is used immediately after the fetal head is delivered to manage the head's position?

<p>Ritgen maneuver (D)</p> Signup and view all the answers

Which type of anesthesia is indicated for labor according to the content?

<p>Epidural anesthesia (C)</p> Signup and view all the answers

What should be done if the fetal head is delivered during childbirth?

<p>Swab the eyelids, nose, and mouth of the fetus (D)</p> Signup and view all the answers

What position should the patient be placed in during the active management of the second stage of labor?

<p>Lithotomy position (D)</p> Signup and view all the answers

What indicates the most severe form of neonatal asphyxia?

<p>White color with absent respiration (A)</p> Signup and view all the answers

Which management step is crucial for ensuring adequate respiration in a newborn with asphyxia?

<p>Using mouth-to-mouth breathing (C)</p> Signup and view all the answers

What is a characteristic feature of asphyxia livida?

<p>Positive respiration (A)</p> Signup and view all the answers

Which of the following is an appropriate prophylactic measure during delivery to prevent neonatal asphyxia?

<p>Proper oxygenation during anesthesia (D)</p> Signup and view all the answers

How should the airway of an infant be cleared immediately after delivery?

<p>Aspirate mucus using suction apparatus (C)</p> Signup and view all the answers

What is the prognosis for asphyxia livida compared to asphyxia pallida?

<p>Asphyxia livida has a good prognosis (A)</p> Signup and view all the answers

Which method is NOT recommended for managing circulation in a newborn with asphyxia?

<p>Cooling the newborn body to lower heart rate (D)</p> Signup and view all the answers

If a newborn has hypoxia due to morphine exposure, what should be administered?

<p>Naloxone (D)</p> Signup and view all the answers

What is the role of ergometrine in the management of the third stage of labor?

<p>To help with placental separation and uterine contraction (D)</p> Signup and view all the answers

What initial step should be taken by a pediatrician after the delivery of the newborn's head?

<p>Wash the mouth to remove mucus or blood (A)</p> Signup and view all the answers

When performing the active method of third stage management, what is the first action taken after the delivery of the anterior shoulder?

<p>Administer ergometrine (A)</p> Signup and view all the answers

What is indicated by an Apgar score of 6 in a newborn?

<p>Moderate asphyxia (A)</p> Signup and view all the answers

Which of the following is NOT a factor assessed in the Apgar score?

<p>Blood pressure (C)</p> Signup and view all the answers

What action should be taken after tying off the umbilical cord?

<p>Cut the cord distal to the clamp and paint the stump with alcohol (C)</p> Signup and view all the answers

During the conservative method of third stage management, what signifies the need for further intervention?

<p>Rise in level of an atonic fundus indicating potential bleeding (C)</p> Signup and view all the answers

What method is used for controlled cord traction during the delivery of the placenta?

<p>Brandt-Andrews method (A)</p> Signup and view all the answers

Flashcards

Active Management of Labor

A method of managing labor that involves close observation, early diagnosis, and intervention to prevent complications.

Antenatal Education

Aims to prepare the mother physically and emotionally for labor, reducing stress during the process.

First Stage of Labor

The first stage of labor, characterized by regular contractions that cause cervical dilation and effacement.

Examination During First Stage of Labor

Involves assessing the mother's overall health, including vital signs, abdominal examination, vaginal examination, and potential investigations.

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Active Procedures During First Stage of Labor

Includes procedures like emptying the bladder and rectum, and preparing the vulva area for delivery.

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Crowning

The moment when the largest diameter of the baby's head (biparietal diameter) is visible at the vaginal opening and doesn't retract between contractions.

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Episiotomy

A procedure where a small cut is made in the perineum (area between the vagina and anus) to prevent tearing during childbirth.

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Ritgen Maneuver

A maneuver to help control the extension of the baby's head during delivery, reducing the risk of perineal tears.

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Onset of the Second Stage of Labor

The first stage of labor ends when the cervix is fully dilated (10 cm), and the second stage begins.

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Delivery of Shoulders

A method to deliver the baby's shoulders after the head is delivered. The anterior shoulder is delivered first by gently lifting the head anteriorly, followed by the posterior shoulder.

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Third stage of labor

The process where the placenta detaches from the uterine wall and is expelled from the body.

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Conservative method

A method of managing the third stage of labor that involves waiting for the placenta to detach naturally and then delivering it.

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Active method

A method of managing the third stage of labor that involves actively promoting placental detachment and expulsion.

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Brandt-Andrews method

A technique used to deliver the placenta after the uterus has contracted by gently pulling on the umbilical cord.

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Ergometrine

A medication that stimulates uterine contractions, often given after delivery of the placenta to help the uterus contract and prevent bleeding.

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Syntocinon (oxytocin)

A medication that stimulates uterine contractions, often given after delivery of the placenta to help the uterus contract and prevent bleeding.

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Apgar Score

A score used to assess a newborn's health immediately after birth based on five key criteria.

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Retained Placenta

A condition that can occur if the placenta is not delivered fully, leading to retained placental tissue.

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Asphyxia Livida

A type of neonatal asphyxia characterized by a blue colour, strong heart beats, positive respiration, muscle tone, and reflexes. It has a good prognosis.

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Asphyxia Pallida

A type of neonatal asphyxia characterized by a white colour, weak heart beats, absent respiration, muscle tone, and reflexes. It has a bad prognosis.

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Management of Neonatal Asphyxia

Essential care for a newborn experiencing asphyxia, focusing on restoring breathing, circulation, and addressing related issues.

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Clear Airway Passage

A procedure to clear the newborn's airway, often involving suctioning mucus.

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Oxygen Supply

Providing supplemental oxygen to a newborn in distress, using methods like face masks or endotracheal tubes.

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External Cardiac Massage

Manual stimulation of the heart, used in cases of newborn heart problems.

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Naloxone

A medication given to newborns experiencing hypoxia due to morphine exposure.

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CNS Stimulants e.g. Couramine

A medication used to stimulate the central nervous system in newborns.

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Study Notes

Management of Normal Labour

  • Active management of labour involves close observation and anticipating the patient's progress, recorded on a partograph. This aids in early diagnosis and management of dysfunctional labour.
  • Advantages of active management include reducing prolonged labour, minimising maternal distress (like dehydration, ketosis), and preventing fetal distress. It also reduces the workload on nursing and medical staff.

Components of Active Management of Labour

  • Antenatal Education: Educating mothers about the physiology of labour aids in preparing them physically and emotionally for the process, reducing stress.
  • Active Management of 1st Stage: Involves a detailed history, examination, including vital signs and physical assessments; cervical examinations, membrane checks, and consideration for pelvic capacity tests for potential disproportion.
  • Active Management of 2nd Stage: Diagnosing the onset of the second stage, transferring the patient to the delivery room in a lithotomy position, ensuring aseptic conditions, and using appropriate analgesia or anesthesia (local or general). Bearing down and delivery procedures are crucial.
  • Active Management of 3rd Stage: Two methods exist: a conservative method focusing on uterine monitoring and massage, and an active method emphasizing active interventions like Brandt-Andrews method (controlled cord traction) to minimize blood loss and expedite delivery of the placenta.
  • Care of Newborn: Immediate care includes clearing the airway, umbilical cord clamping and care, observing vital signs, and implementing measures to prevent ophthalmia neonatorum.

Antenatal Education

  • Aims to educate mothers physically and emotionally to alleviate potential stress during labour.

Active Management of 1st Stage of Labour

  • History: This section includes complete obstetric history, present pregnancy history, and present labour history (pain, bleeding, fluid release, fetal movement).
  • Examination: Details general assessment (vital signs), abdominal examination (fetal heart sounds, abdominal grips), and pelvic examinations (cervical dilation, effacement, presentation, position, and station).
  • Investigations and procedures may include checking blood group and Rh factor, urine analysis, and blood haemoglobin levels; bladder and rectum evacuation, skin preparation, and nutritional assessment.

Active Management of 2nd Stage of Labour

  • Diagnosis of Onset of 2nd Stage: Identifying the start of this stage is critical.
  • Transfer and Positioning: Positioning the patient correctly in the delivery room (lithotomy) is important.
  • Asepsis: Maintaining cleanliness and sterilization procedures for both the patient and staff during this stage.
  • Analgesia or Anesthesia: This crucial step may involve local anesthetic options like pudendal nerve blocks, local infiltration, or even general anesthesia.
  • Bearing Down: Encouraging the patient's effort during contractions.
  • Delivery of Fetus: Procedures involve crowning assessment, episiotomy if needed, gently delivering the head, shoulders, and body.

Managemenet of 3rd Stage of Labour

  • Two methods, conservative and active exist
  • Active methods involve expedited placenta delivery with interventions like controlled cord traction.

Care of the Newborn

  • Initial steps involve clearing the airway, inspecting for anomalies, administering vitamin K, umbilical cord ligation, and ophthalmic prophylaxis.
  • Apgar score assessment evaluates the newborn's vital signs.

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Management Of Normal Labour PDF

Description

This quiz covers the principles and practices of managing normal labour, emphasizing the active management approach. Learn about the components involved, including antenatal education and the management of the first and second stages of labour. Understand the benefits of active management for both mothers and healthcare providers.

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