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29 Cards in this Set

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When does labor normally begin?
When the fetus is sufficiently mature to cope with extrauterine life. Not too large to cause mechanical difficulties with birth.
what is the triiger that convert the random,painless Braxton Hicks contractions into strong coordinated, productive labor contractions?
it is unknown
what is preterm birth
labor that begins before a fetus is mature
what is postterm birth
labor that is delayed until the fetus and the placenta have both passed beyon the optimal mpoint for birth.
labor is influenced by a combination of factors originating from
mother and fetus
Uterine muscle stretches
release of prostiglandins
pressure on the cervix
stimulates the release of oxytocin from the pituitary gland
oxytocin stimulation
works together with prostiglandins to initiate contractions
change in the ratio of estrogen to progesterone (increasing estrogen in relation to progesterone}
stimulates uterine contractions
placental age
automatically triggers contractions at a set point
rising fetal cortisol levels
reduce progesterone and increase prostiglandins
fetal membrane production of prostiglandins
stimulates contractions
preliminary signs of labor
subtle. women must be taught so they can recognize when labor is beginning.
Lightening
descent of fetal presentation. usually 10-14 days before labor begins.
1. changes a woman's abdominal contour
2. uterus becomes lower and more anterior.
3. relief from the diaphragmatic pressure and shortness of breath ("lightens the load")
4.early in primiparas because of tight abd muscles.
5. multiparas- not as dramatic and usually occurs on the day labor begins or even after.
6. as the fetus sinks lower in the pelvis, the mother may experience
1.shooting pains in legs from the increased pressure on the sciatic nerve, increased amounts of vaginal discharge, and urinary frequency from the pressure on the bladder.
increase in level of activity
morning of labor- more energy d/t epinepherine release
epinepherine
1. initiated by a decrese in progesterone produced by the placenta.
2. prepares woman's body for the work of labor ahead.
Braxton Hicks Contractions
False labor.
1.last week or days before 2.true labor begins.
3.strong.
4.woman may come to hosp thinking that she is in labor
sent home
5.very discouraging
6.emotional support and
teaching re. Braxton Hicks vs. True labor
False Contractions
1.begin and remain irreg
2.felt 1st in abd, remain confined to abd and groin
3.often disappear w/amb and sleep
4.do not increase in duration, frequency, or intensity
5.do not achieve cervical dilatation
True Contractions
1.begin irreg, become reg and predictable
2.felt 1st in lower back and sweep around to the abd in a wave
3.cont no matter what the woman' level of activity
4.increase in duration, frequency, and intensity
5.achieve cervical dilatation
uterince contractions
1.surest sign of labor
2.involuntary and w/o warning
3.intensity can be frightening
Give the woman a sense of control during uterine contractions by
1. helping her appreciate that she can predict her pattern and therefore can control the degree of discomfort
how can a woman predict her pattern and control the degree of discomfort?
she feels by using breathing exercises
Show
bloody show
mucus plug expelled
streaked w/blood, usually pink
teach moms it does NOT mean they are bleeding
think of a cork coming out of a wine bottle
rupture of membranes
"water breaking"
sudden gush or leaking
clear fluid
advantage of early rupture of membranes
it may cause the fetal head to settle snugly into the pelvis
shortens labor
Risks with ruptured membranes
intrauterine infection
prolapse of the fetal cord (can cut off O2 supply to the fetus)
what happens if labor does not begin 24hrs after ruptured membranes?
labor is induced to help reduce these risks
what can we teach woman about ruptured membranes and "dry labor" (difficult and long)?
amniotic fluid continues to be produced until delivery of the membranes after birth of the fetus so no labor is ever "dry"