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Questions and Answers
What is the definition of normal labor?
What is the definition of normal labor?
At what gestational age is a fetus considered mature for the context of normal labor?
At what gestational age is a fetus considered mature for the context of normal labor?
Which of the following best describes the first stage of labor?
Which of the following best describes the first stage of labor?
Why is spontaneous expulsion important in defining normal labor?
Why is spontaneous expulsion important in defining normal labor?
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Which option is NOT a characteristic of normal labor?
Which option is NOT a characteristic of normal labor?
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What is the cervical mucus plug commonly referred to in the context of pregnancy?
What is the cervical mucus plug commonly referred to in the context of pregnancy?
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What causes the blood mentioned in the content?
What causes the blood mentioned in the content?
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During which condition is the cervical mucus plug particularly significant?
During which condition is the cervical mucus plug particularly significant?
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What does the separation of the bag of membrane from the lower uterine segment lead to?
What does the separation of the bag of membrane from the lower uterine segment lead to?
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Which of the following statements is true concerning the cervical mucus plug?
Which of the following statements is true concerning the cervical mucus plug?
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Study Notes
Part 1: Area 2 (2024)
- This section is about obstetric practice.
- Images of a baby and a fetus are shown.
First Stage of Labor
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Definition of Normal Labor:
- Spontaneous expulsion of a mature fetus (37-42 weeks).
- Single viable fetus.
- Vertex occipitoanterior position (left or right).
- Within a reasonable time (3-24 hours).
- No surgical intervention (except episiotomy).
- No complications for the mother or baby.
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Stages of Normal Labor:
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First Stage: Cervical dilatation and effacement.
- Start: True labor pain.
- End: Full cervical dilatation.
- Duration: 12-16 hours (primigravida), 6-8 hours (multipara)
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Second Stage: Delivery of the pelvic.
- Start: Full cervical dilatation.
- End: Delivery of the fetus.
- Duration: 1-2 hours (primigravida), 0.5-1 hour (multipara)
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Third Stage: Delivery of the placenta.
- Start: Delivery of the fetus.
- End: Delivery of the placenta.
- Duration: 5-30 minutes
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Fourth Stage: Observe complications after full labor.
- Duration: 2 hours
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First Stage: Cervical dilatation and effacement.
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Prodromal Phase:
- Lightening
- Increased urinary frequency
- Labour pains
Procedure
- Handwashing
- Preparing equipment
- Ensuring privacy
- Assisting patient if complications exist (bleeding, PROM, high BP, cardiac issues)
- Determining if the woman is in labor.
True Labor Pain vs. False Labor Pain
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True Labor Pain:
- Regular, increasing frequency and duration as labor progresses.
- Begins in the lower abdomen, radiating to the back.
- Accompanied by cervical dilatation and bulging of the membranes.
- Not relieved by analgesics.
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False Labor Pain:
- Irregular, decreasing frequency and duration.
- Begins in the lower abdomen.
- Not accompanied by cervical dilatation or bulging of the membranes.
- Relieved by analgesics.
Uterine Contractions
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Latent Phase:
- Frequency: 1 contraction every 10 minutes.
- Duration: 20 seconds.
- Intensity: Uterus can be dented.
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Active Phase:
- Frequency: 3 contractions every 10 minutes.
- Duration: 40-60 seconds.
- Intensity: Uterus is felt hard.
Membranes
- Ask if woman experienced fluid leakage.
- If uncertain, use litmus paper or smell the fluid to rule out urine.
- Record rupture time.
Cervical Changes
- Shortening and dilation of the cervix.
- Latent Phase: Cervical dilation less than 3 cm.
- Active Phase: Cervical dilation from 3-10 cm
- Primigravida: Cervix dilates about 1.2 cm/hr.
- Multigravida: Cervix dilates about 1.5 cm/hr
Cervical Effacement
- Caused by uterine contraction and retraction.
- Prostaglandin release due to pressure on the cervix before membrane rupture.
Nursing Management Steps (First Stage)
- History taking (personal, medical, family, obstetric, menstrual, contraceptive history).
- General examination (abdominal).
Investigations
- Urine sample (protein and sugar testing—mid-void sample after vaginal swab, before enema).
- Complete blood count (CBC).
- HIV test.
- Hepatitis B test.
- Kidney and liver function tests.
- Blood group and Rh factor
Vaginal Examination
- Internal examination of vagina and cervix.
- Indications:
- Assessing the cervix (dilatation, consistency, position).
- Assessing the fetus (engagement, position, lie, presentation, station).
- Contraindications:
- Specific conditions; consult doctors
- Useful for assessing cervical condition and fetal positioning.
Contraindications for Vaginal Exam
- Specific patient conditions
Placenta, Vasa Previa, Early Rupture of Membranes
- Placenta Praevia: Placenta covers the cervix opening
- Vasa Previa: Fetal vessels run across the cervix.
- Early Rupture of Membranes (PROM): Rupture before labor onset.
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Description
Explore the key concepts of the first stage of labor in obstetric practice. This quiz covers definitions, normal labor parameters, and the duration of different stages. Images related to fetal development are included for a comprehensive understanding.
