SS_OB 1.8 Describe the anatomy and physiology of pain in labour and childbirth

T / F  Pain associated with the first stage of labour is visceral pain – dull, poorly localised, and felt in the lower abdomen or back. It is caused by cervical dilation, and increasing pressure in the lower uterine segment.

T / F  Nociception in the first stage occurs via A-delta and C fibres that travel with the sympathetic efferents. They eventually enter the neuraxis via the T10 – L1 nerve roots.

T / F  Pain associated with the second stage of labour is predominantly somatic pain – localised to the perineum. It is caused by stretching and tearing of the vagina and perineal skin.

T / F  Nociception in the second stage is transmitted via the pudendal nerves, which enter the neuraxis via the S2 – S4 nerve roots.

T / F  An epidural block to T10 would be adequate for labour, but needs to be extended to T4 for a Caesarian, in order to cover most of the peritoneal contents.

T / F  Ice is used to assess an epidural or spinal block, because input from thermoreceptors is transmitted via the same A-delta and C fibres that transmit pain.

References:
1. Macintyre etal. Clinical Pain Management: Acute Pain, 2nd edition 2008, Chapter 26.
2. Guyton 12th edition, Fig 46-6

 

Obs, Obs, Baby.

SS_OB 1.6 Describe the changes in the anatomy of the maternal airway and their impact on airway management during anaesthesia.

SS_OB 1.1 Describe the physiological changes and their implications for anaesthesia that occur during pregnancy, labour and delivery.

The increased risk of airway bleeding during manipulation is primarily due to platelet dysfunction in pregnancy. TRUE/FALSE

Lung compliance decreases in pregnancy. TRUE/FALSE

Closing capacity increases during pregnancy. TRUE/FALSE

Oxygen consumption is increased at term, regardless of whether the patient is in labour or not. TRUE/FALSE

Airway oedema can occur due to venous engorgement from labour. TRUE/FALSE