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Questions and Answers

What is the definition of normal labour?

Expulsion of single mature fetus within 36 hours

Expulsion of single immature fetus within 24 hours

Expulsion of single mature fetus within 24 hours (correct)

Expulsion of twins within 24 hours

What is the duration of labour in prolonged labour?

Less than 12 hours

Less than 24 hours

More than 24 hours (correct)

Exactly 24 hours

What is the characteristic of true labour pain?

Affected by sedation

Accompanied by relaxation of the uterus

Irregular, decrease in amplitude, frequency and duration

Regular, increase in amplitude, frequency and duration (correct)

What is the cause of precipitate labour?

Strong uterine contractions (D) Signup and view all the answers

What is the significance of show in labour?

It is a sign of true labour (B) Signup and view all the answers

What is the duration of pregnancy in post-mature labour?

More than 42 weeks (C) Signup and view all the answers

What can cause prolonged labour?

Uterine inertia (B) Signup and view all the answers

What is false labour pain characterized by?

Women complains of painful uterine contractions while progressive dilatation of cervix fails to occur (C) Signup and view all the answers

What is the frequency of TENS during uterine contraction?

80-120 Hz (D) Signup and view all the answers

What is the pulse width of TENS?

150 micro-second (B) Signup and view all the answers

What is the position of the mother during the second stage of labour?

Lithotomy position (D) Signup and view all the answers

What is the purpose of supporting the perineum during the second stage of labour?

To reduce the risk of perineal laceration (C) Signup and view all the answers

What is the purpose of massaging the uterus during the third stage of labour?

To reduce the risk of postpartum hemorrhage (A) Signup and view all the answers

What is a contraindication for postpartum exercise?

Postpartum hemorrhage (A) Signup and view all the answers

What is a value of postpartum exercise?

To reduce the risk of respiratory complications (B) Signup and view all the answers

Where is the lower set of TENS placed during the second stage of labour?

The anterior aspect of the lower abdomen in a V shape (A) Signup and view all the answers

What is the characteristic of contractions in false labour?

Intensity of contraction remains the same (D) Signup and view all the answers

What is the pH of amniotic fluid?

Alkaline (B) Signup and view all the answers

What is the primary function of amniotic fluid after rupture of membrane?

Acts as anti-septic fluid for birth canal (B) Signup and view all the answers

What is the duration of the first stage of labour in multigravida?

6-8 hours (B) Signup and view all the answers

What is the purpose of deep breathing exercise during the first stage of labour?

To promote relaxation (D) Signup and view all the answers

Why should the mother lie down after rupture of membrane?

To prevent leakage of liquor amnii (D) Signup and view all the answers

What is the benefit of using TENS during labour?

Decreases the length of labour (B) Signup and view all the answers

Where should the electrodes be placed for TENS during labour?

Paravertebrally over nerve root (A) Signup and view all the answers

What is the main purpose of postpartum exercises?

To restore muscle tone and promote lactation (A) Signup and view all the answers

What is the benefit of episiotomy in preventing perineal lacerations?

It helps in repairing surgical incision more successfully than jagged tear (B) Signup and view all the answers

What is the main benefit of median episiotomy?

It extends posterior along the midline of the perineum (B) Signup and view all the answers

What is the main purpose of pelvic floor exercises in postpartum?

To guard against pelvic floor dysfunctions (C) Signup and view all the answers

What is the benefit of postpartum exercises on the first day?

It helps in relaxation of the face (A) Signup and view all the answers

What is the benefit of postpartum exercises in improving lactation?

It improves blood supply in the pectoral region (C) Signup and view all the answers

What is the purpose of leg exercises on the second day of postpartum?

To improve blood supply in the lower limbs (C) Signup and view all the answers

What is the main benefit of arm exercises in postpartum?

It helps in re-education of postural sense (D) Signup and view all the answers

What is the aim of physical therapy after episiotomy?

To relieve pain at the site of incision, promote healing of incision, and improve positioning (A) Signup and view all the answers

What is the frequency of Pulsed ElectroMagnetic Energy (PEME) used to relieve perineal pain?

27 MHZ (A) Signup and view all the answers

How is ultrasonic therapy applied?

Under water or water-filled codon (B) Signup and view all the answers

What is the duration of Low-Level LASER therapy used to relief perineal pain?

10-15 minutes (D) Signup and view all the answers

What is the wavelength of Low-Level LASER therapy used to promote wound healing?

600-750 nm (D) Signup and view all the answers

What is the pulse rate of Pulsed ElectroMagnetic Energy (PEME) used to relieve perineal pain?

100/second (C) Signup and view all the answers

What is the comfortable position recommended for postnatal care with episiotomy?

SUPINE WITH CROSSED LEGS (A) Signup and view all the answers

What is the purpose of ice application in the management of postnatal case with episiotomy?

To relieve edema of the perineum and subsequently relieve perineal pain (A) Signup and view all the answers

Study Notes

Normal Labour

Definition of Labour: Act of expulsion of fetus and placenta from uterus
Definition of Normal Labour: Expulsion of single mature fetus, presenting by the vertex, through birth canal within 24 hours, without fetal and maternal complications
Objectives: Define normal labour, know onset and stages of labour, integrate physical therapy program, and design physical therapy program postpartum

Definitions

Post Mature Labour: Duration of pregnancy is 42 weeks or more
Prolonged Labour: Duration of labour lasts more than 24 hours due to uterine inertia, occipito-posterior position, rigid perineum, full bladder and rectum
Precipitate Labour: Duration of labour lasts less than 3 hours due to strong uterine contractions, no obstruction in birth canal, and lack of resistance of soft tissues

The Onset of Labour

Show: Discharge of mucous mixed with blood due to dilatation of cervix
True Labour Pain: Characterized by regular, increase in amplitude, frequency, and duration, accompanied by hardening of the uterus, discomfort in both back and abdomen, and accompanied by progressive dilatation of cervix
False Labour Pain: Characterized by irregular contraction, intensity of contraction remains the same, discomfort in lower abdomen only, and contractions are usually relieved and stopped by sedation
Rupture of Membrane: Associated with gush of amniotic fluid, and women should go to hospital immediately due to danger of cord prolapse

Stages of Labour

First Stage (Stage of Cervical Dilatation): Begins with onset of labour and ends with complete cervical dilatation, duration of 8-12 hours in primigravida and 6-8 hours in multigravida
Management of First Stage of Labour: Mother should choose preferable relaxed position, practice deep breathing exercises, prevent straining, walk in intervals between pain, and empty bladder and rectum every 2 hours
Use of TENS: For pain control, reduce length of labour, and decrease dependence on narcotics during and after labour

Second Stage (Stage of Expulsion of the Fetus)

Extends from full dilatation of cervical to complete birth of the infant, duration of 2nd stage ranges from few minutes to one hour
Management of Second Stage of Labour: Mother lies in lithotomy position, instructed to take deep breath and bear down during uterine contractions, and perineum must be supported with uterine contraction to avoid perineal laceration

Third Stage (Stage of Expulsion of Placenta and Membrane)

Is the period from the birth of the infant to delivery of placenta and membrane
Management of Third Stage of Labour: Massaging the uterus during separation and descend of the placenta, inspect the external genitalia and perineum, and observe the mother carefully for one hour for fear of postpartum hemorrhage

Post Partum Exercise

Contraindications: Postpartum hemorrhage, nephritis, and puerperal fever
Values of Post Partum Exercise: Prophylactic, curative, and lactational
Post Partum Exercises: Circulatory exercises, respiratory exercises, static abdominal contraction, relaxation on face, and pelvic floor exercises

Episiotomy

Definition: An incision of the perineum aiming to widen the vaginal enteroitus and facilitate passage of the fetus
Values of Episiotomy: Prevent perineal lacerations, relieve compression on the fetal head, prevent stretch of pelvic floor, and surgical incision repaired more successfully than jagged tear
Types of Episiotomy: Median episiotomy and medio-lateral episiotomy

Management of Post Natal Case with Episiotomy

Aim of Physical Therapy: Relieve pain at the site of incision, promote healing of incision, and positioning
Physical Therapy Modalities: Ice application, ultrasonic, pulsed electromagnetic energy (PEME), and low-level laser therapy

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