Birth Process: Labor And Delivery

Front 1

What makes up the birth passage?

Back 1

The bony pelvis and the muscles of the pelvic floor and perineum.

Front 2

The inlet of the true pelvis is widest where? narrowest?

Back 2

Widest: Transverse
Narrowest: A-P

Front 3

The outlet of the true pelvis is widest where? narrowest?

Back 3

Widest: A-P
Narrowest: Transverse

Front 4

What are the four types of pelvises?

Back 4

- Android
- Anthropoid
- Gynecoid
- Platypelloid

Front 5

What two of the four pelvises are adequate for labor and delivery?

Back 5

- Gynecoid
- Anthropoid

Front 6

Which pelvis looks more like a male pelvis?

Back 6

- Android

Front 7

What are the 5 bones found in the fetal head?

Back 7

- 2 frontal
- 2 parietal
- 1 occipital

Front 8

What are the names of the 4 sutures in a fetal head?

Back 8

- Sagittal
- Lambdoidal
- Coronal
- Frontal

Front 9

When a fetus is said to be laying longitudinal, in what position is it in?

Back 9

Up and down, either head up or head down

Front 10

When a fetus is said to be laying transverse, in what position is it in?

Back 10

Across the uterus, head is either to the left or right side

Front 11

Do you want a flexion or extension attitude?

Back 11

- Flexion

Front 12

What does it mean if a fetus' attitude is flexion?

Back 12

The body is tightly flexed, top of the head should come out first

Front 13

What does it mean if a fetus' attitude is extension?

Back 13

Head is extended so a face presentation is possible, arms and legs are not tightly flexed against the body

Front 14

Out of flexion and extension which one would go to a C-section?

Back 14

Extension

Front 15

What are the three categories for fetal presentation?

Back 15

- Cephalic
- Breech
- Shoulder

Front 16

What is cephalic presentation? And what four groups can it be divided into?

Back 16

- Fetal head presents first and is divided into groups according to the relation of the fetal head to its body
- vertex, military, brow, face

Front 17

What is a breech presentation? And what 3 groups can it be divided into?

Back 17

- The buttocks/ feet present first
- frank, full or complete, incomplete

Front 18

A frank breech is when?

Back 18

The legs are flexed at the hips and the knees and legs are extended against the abdomen and chest, buttocks is the presenting part

Front 19

What is the most common kind of breech?

Back 19

65%

Front 20

A complete/full breech is when?

Back 20

The legs are flexed up on the fetal abdomen and the knees are flexed, buttocks and/or feet are the presenting parts

Front 21

An incomplete breech is when?

Back 21

the legs are flexed up on the fetal abdomen and one of the legs are flexed a the knee and the other is extended (foot by head)

Front 22

A shoulder presentation is the same as ?

Back 22

A transverse lie

Front 23

Fetal station is defined as?

Back 23

Measures degree of descent of the presenting part of the fetus through the birth canal

Front 24

How is fetal station measured?

Back 24

Up or down in cm from the ischial spines

Front 25

In measuring fetal station, if the fetus was at the ischial spines what station is it at?

Back 25

O

Front 26

If a fetal station has a negative sign, you know the fetus is above or below the ischial spines?

Back 26

Above

Front 27

If a fetal station has a positive sign, you know the fetus is above or below the ischial spines?

Back 27

Below

Front 28

Define fetal engagement

Back 28

when the fetal head reaches the level of the ischial spines

Front 29

When does engagement usually happen in a primigravida?

Back 29

About 2 weeks before labor begins

Front 30

When does engagement usually happen in a multigravida?

Back 30

May not happen until labor begins

Front 31

What does effacement mean?

Back 31

Thinning of the cervix

Front 32

The pelvis is divided into 4 quadrants, what are they? Are they viewed from your view or the patient's view?

Back 32

- Right, left, anterior, posterior
- They are viewed from the patient's point of view

Front 33

What 3 characteristics distinguish true labor from false labor?

Back 33

- Contractions
- Discomfort
- Cervical change

Front 34

What is fetal position?

Back 34

- Relationship of a designed landmark on the presenting part to four imaginary quadrants of the maternal pelvis

Front 35

How is fetal position described?

Back 35

By a 3 letter abbrevation

Front 36

What is the first abbreviation in fetal position?

Back 36

R or L: Right or left side of the maternal pelvis

Front 37

What is the second abbreviation in fetal position?

Back 37

Specific presenting part of the fetus:
Occiput (O): vertex presentation
Mentum (M): face presentation
Sacrum (S): breech presentation
Accordion (A): shoulder presentation

Front 38

What is the third abbreviation in fetal position?

Back 38

Location of the presenting part in relation to the maternal pelvis:
Anterior (A)
Posterior (P)
Transverse (T)

Front 39

What location on the fetus are heart tones heard best?

Back 39

Fetal back or chest

Front 40

If a fetus is breech where on the mother's abdomen would you hear them?

Back 40

Right or left upper quadrants

Front 41

If the fetus is vertex where would their heart tones be heard?

Back 41

below maternal umbilicus

Front 42

What is the purpose of a ctx?

Back 42

Accomplishes effacement and dilatation of the cervix and facilitates fetal descent through the pelvis

Front 43

How many mins do you need between ctx?

Back 43

1 min

Front 44

True or False
The uterus divides into 2 segments in the process of labor, the upper and lower.

Back 44

True

Front 45

Effacement is expressed in terms of?

Back 45

%

Front 46

If you were to read this on a chart what would it mean, 5/90/+1?

Back 46

5 cm dilated, 90% effaced, +1 station

Front 47

How many stages of labor are there?

Back 47

4

Front 48

What is dilatation? how is it measured?

Back 48

- Widening of cervical opening and cervical canal
- Measured via vaginal exam, in cm 1-10

Front 49

Can a women push if her cervix is not fully dilated?

Back 49

No, needs to be completely (10cm) dilated

Front 50

Do effacement and dilatation take place together in multigravida women? primigravida?

Back 50

Multigravida- yes
Primigravida- no, effacement starts first

Front 51

When does the first stage of labor begin and end?

Back 51

Begins with onset of true labor and ends with complete dilatation

Front 52

There are 3 phases in the first stage of labor what are they?

Back 52

- Latent phase
- Active phase
- Transitional phase

Front 53

When does the latent phase begin and end?

Back 53

Begins with the initiation of regular ctx and ends when the cervix is 3 cm

Front 54

How long is the latent phase in nullipara? multipara?

Back 54

Nullipara: 8.6 hrs
Multipara: 5.3 hrs

Front 55

What is a women's behavior like in the latent phase?

Back 55

Comfortable, joking around, talkative, independent

Front 56

Describe the ctx in the latent phase

Back 56

- Every 10-30 mins to 5-7 mins
- 30-40 secs in duration
- Mild to moderate intensity

Front 57

When does the active phase begin and end?

Back 57

Begins at 4 cm dilatation and ends at 7 cm

Front 58

How long is the active phase in nullipara? multipara?

Back 58

Nullipara: 4.6 hrs
Multipara: 2.4 hrs

Front 59

How is the women's behavior in the active phase of labor?

Back 59

Helplessness, increased fatigue, restlessness, more dependent

Front 60

When does the transitional phase begin and end?

Back 60

Begins at 8 cm and ends at 10 cm

Front 61

How long is the transitional phase in the nullipara? multipara?

Back 61

Nullipara: 3.6 hrs
Multipara: mins to hrs

Front 62

How often should the B/P be taken during the first stage of labor?

Back 62

Must be taken between every ctx

Front 63

What is the average amount of amniotic fluid?

Back 63

1,000- 1,500 mL

Front 64

If too little amniotic fluid what is the baby at risk for? if too much?

Back 64

Too little: cord compression
Too much: cord prolapse

Front 65

What is priority thing to do when a women's water breaks?

Back 65

Check fetal heart tones

Front 66

True or False
Meconium is normal in a breech

Back 66

True

Front 67

The second stage of labor begins and ends with what?

Back 67

Begins with complete dilatation of cervix and ends with birth of baby

Front 68

How long does the second stage of labor last in nullipara? multipara?

Back 68

Nullipara: up to 3 hrs, not more than 4 hrs
Multipara: less than 1 hr, usually 15 mins

Front 69

Is a women usually pushing in the second stage of labor?

Back 69

Yes

Front 70

How long can a women push for?

Back 70

max 4 hrs

Front 71

What are the Cardinal movements of labor?

Back 71

- Descent
- Flexion
- Internal Rotation
- Extension
- Restitution
- External Rotation
- Explusion

Front 72

What does the third stage of labor begin and end with?

Back 72

Begins with birth of the infant and ends with delivery of the placenta

Front 73

True or False
Every women gets pitocin after delivery.

Back 73

True

Front 74

If a women is having post partum hemorrhage what vital sign will she not maintain?

Back 74

Temp

Front 75

When are pregnant women screened for GBS?

Back 75

35-37 weeks

Front 76

If a women is GBS positive when is treatment most effective for the fetus?

Back 76

at least 4 hrs before delivery