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67 Cards in this Set
- Front
- Back
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what is the definition of labor?
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process by which the fetus is expelled from the uterus
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what does labor require? (3)
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contraction
dilation effacement |
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how are contractions described?
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quantitatively
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what are equally important as contraction frequency? (3)
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duration
intensity relaxation |
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what are considered normal contractions?
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5 or less contractions in 10 minutes, arranged over a 30 minute window
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what is tachysystole?
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more than 5 contractions in 10 minutes, averaged over a 30 minute window
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why is tachysystole important?
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uterus is contracting so much that the fetus will not be adequately oxygenated
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what type of contractions do we expect to see with cervical dilation?
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normal
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what does the success of pushing the fetus through the birth canal depend on?
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3 Ps
power passenger passage |
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what is power?
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the force generated by the contraction of the uterine myometrium
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what is passage?
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the bony pelvis and soft tissues of the birth canal
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what is fetal lie?
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orientation of the fetal spine relative to the spine of the mother
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what are 6 types of presentation?
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vertex
brow facial breech shoulder compound |
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if the baby's head is down in the pelvis, what presentation is it?
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vertex
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what is considered an emergency?
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a compound presentation involving the umbilical cord
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if a baby presents through the birth canal with an arm and it's head, what type of presentation is it?
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compound
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what are 4 breech presentations?
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complete
incomplete frank footling |
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which type of breech presentation cannot be delivered vaginally?
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footling
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wha is the typical fetal attitude?
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flexed
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what is fetal attitude?
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degrees of flextion/extension of the head
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what are 2 non-normal attitudes?
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neutral
deflexed |
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what is the expected fetal position?
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left occiput anterior
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what is fetal position?
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relationship of the fetal presenting part to the maternal pelvis
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what are the 2 phases of the first stage of labor?
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latent
active |
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what is the latent phase?
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cervical effacement and early dilation
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what is the active phase?
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rapid cervical dilation which begins when the cervix is 3-4cm
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what occurs in the 2nd stage?
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feeling the desire to bear down with each contraction
delivery of the baby |
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what is the time frame to delivery from the 2nd stage in a nuliparous pregnancy?
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30min - 3 hrs
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what is the time frame to delivery from 2nd stage in a multiparous pregnancy?
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5-30min
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what is the third stage of labor?
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placental separation within 2-10 mins
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what should you do in the 3rd stage?
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inspect the vagina for bleeding and lacerations
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what are 4 signs of placental separation?
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fresh gush of blood from vagina
umbilical cord lengthening fundus of the uterus rises up usterus becomes globular and firm |
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what are these a sign of?
fresh gush of blood from vagina umbilical cord lengthening fundus of the uterus rises up usterus becomes globular and firm |
placental separation
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what is the 4th stage of labor?
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observation after delivery for signs of bleeding
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how long do you expect the first stage to take in an nulipara mother?
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6-18 hours
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how long do you expect the first stage to take in a multipara mother?
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2-10 hours
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how fast do you expect the cervix to dilate in a nulipara mother?
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1cm/hour
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how fast do you expect the cervix to dilate in a multipara mother?
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1.5cm/hour
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what is effacement?
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the thinning of the uterus
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what is the normal thickness of the cervix?
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2cm
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what is considered a term pregnancy?
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37 weeks to 40
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what is station?
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a measurement of decent of the baby
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what is the current standard classification of station?
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-5 to 5
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what is the midpoint (0 station)?
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the plane of the maternal ischial spines
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when is the baby's head considered engaged?
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0 station
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how do you describe labor?
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dilation, effacement, station
i.e. 6, 90, +2 |
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what is engagement?
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a cardinal movement of labor
refers to the passage of the widest diameter of the presenting part to a level below 0 station |
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what is flexion?
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a cardinal movement of labor
occurs as the head descends through the bony pelvis |
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what is internal rotation?
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a cardinal movement of labor
rotation of the presenting part from its original position as it enters the pelvic inlet |
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what are the 7 cardinal movements of labor?
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engagement
flexion descent internal rotation extension external rotation expulsion |
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how do you quantitate baseline variability in fetal heart monitoring?
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amplitude of peak-to-trough beats/min
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what is an early deceleration?
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a gradual decrease of the fetal heart rate that occurs with the peak of contraction
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what does early deceleration represent?
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head compression
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how long does early deceleration take from the onset to the nadir?
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>30 seconds
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how long does variable deceleration last from onset to nadir?
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<30 seconds
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when will you not be able to see much variability on fetal heart monitoring?
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less than 24 weeks
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if you don't see fetal variability by when should you get worried?
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28 weeks
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what is variable deceleration?
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an abrupt decrease in FHR of >15 beats per minute
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what does variable deceleration represent?
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cord compression
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what are 3 types of fetal heart deceleration?
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early
variable late |
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when does late deceleration occur?
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after the beginning of the contraction so that the nadir of deceleration occurs after the peak of the contraction
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what does late deceleration represent?
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placental insufficiency
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what are 6 maternal indications for c-section?
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specific cardiac disease
specific respiratory disease conditions associated with increase intracranial pressure mechanical obstruction of the lower uterine segment mechanical vulvar obstruction herpes |
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what are 2 examples of cardiac diseases that would require c-section?
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marfans
unstable coronary artery disease |
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what is a specific respiratory disease that will require c section?
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guillian barre syndrome
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what are 4 maternal-fetal indications for c-section?
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cephalopelvic disproportion
placental abruption placenta previa elective cesarean |
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what are 5 fetal indications for c-section?
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nonreassuring fetal status
breech or transverse lie maternal herpes congenital anomolies beta-strep infection |
