Mechanism and Management of Labour - Dr Nyan Kamal Rasheed

Definitions and Key Concepts

• Labour is the process of childbirth, involving uterine contractions leading to cervical dilation and delivery of the fetus.
• The '3Ps' of labour refer to Passenger (baby), Passage (birth canal), and Powers (contractions), all contributing to the success of labor.

Outcomes of Favourable '3Ps'

• Favourable conditions of the 3Ps are likely to result in a smoother and shorter labour process, decreasing the need for interventions.

Multidisciplinary Team in Abnormal Labour

• The management of abnormal labour should involve obstetricians, midwives, nurses, anaesthetists, and paediatricians, all working collaboratively.

Health Professionals' Awareness

• Professionals must recognize the signs of abnormal labour and monitor maternal and fetal well-being to effectively manage complications.

Role of Midwifery Care

• Midwifery care in normal labour focuses on supporting the mother, providing education, and ensuring comfort and safety during the birthing process.

Likely Outcomes for Abnormal Labour

• Abnormal labour often leads to increased likelihood of interventions such as caesarean sections, instrumental deliveries, or prolonged hospital stays.

'The Passage' in Maternal Labour

• 'The Passage' refers to the birth canal through which the baby passes, including the pelvis and soft tissues.

Role of 'The Passenger'

• 'The Passenger' is the fetus, and its position, size, and presentation significantly impact the labour process and delivery.

Maternal Pelvic Floor in 'The Passage'

• The maternal pelvic floor included in 'The Passage' comprises muscles and tissues that support pelvic organs and facilitate delivery.

Landmarks for Fetal Station Assessment

• Landmarks for assessing fetal station during vaginal examination include the ischial spines and the top of the pubic symphysis.

Role of the Pudendal Nerve

• The pudendal nerve is crucial during labour as it provides sensation to the perineum and facilitates voluntary control during delivery.

Pelvic Inlet Structure

• The pelvic inlet is formed by the bony pelvis, specifically the sacrum, ilium, and pubic bones, creating a tunnel for the fetus to pass through.

Normal Transverse Diameter of the Pelvic Inlet

• The normal transverse diameter of the pelvic inlet averages about 13 cm, allowing adequate space for fetal passage.

Shape of the Midpelvis (Midcavity)

• The midpelvis has an oval to round shape, influencing how the fetus navigates the birth canal during descent.

Learn about the mechanism and management of labour from Dr Nyan Kamal Rasheed, a Fellow of the Royal Australian & New Zealand College of Obstetricians & Gynecologists. This quiz covers definitions of labour, physiological processes, and more related to childbirth.