Maternal Newborn - Test 2 Chapter 18

Front 1

Passenger
--the way the passenger, or fetus, moves through the birth canal is determined by many factors:

fetal head

Back 1

-the size of the fetal head (anterior fontanel closes by 18 months after birth and the posterior closes 6-8 weeks after birth) because the bones are not firmly united, slight overlapping of the bones, or molding of the shape of the head occurs during labor)

Front 2

Passenger
-the way the passenger, or fetus, moves through the birth canal is determined by many factors

-fetal presentation, refers to:

what are the 3 main positions?

Back 2

refers to the part of the fetus that enters the pelvic inlet first and leads through the
birth canal during labor

-3 main presentations are cephalic presentation (head first),
breech presentation (buttocks or feet first) and shoulder presentation.

Front 3

the presenting part is that part of the fetal body first felt by the examining finger during a

Back 3

vaginal examination

Front 4

Passenger
--the way the passenger, or fetus, moves through the birth canal is determined by many factors:

3 others

Back 4

fetal lie:
-fetal attitude
-fetal position

Front 5

What is the "passenger"

Back 5

-b/c the placenta has to pass through the birth canal, it can be considered a passenger along with the fetus

Front 6

Primary powers:
-responsible for

Back 6

effacement ,dilation of the cervix, and descent of the fetus

Front 7

-effacement of the cervix means

Back 7

the shortening and thinning of the cervix during the first stage of labor

Front 8

: the enlargement or widening of the cervical opening and the cervical canal that occurs once labor has begun.

Back 8

dilation

-the diameter of the cervix increases from less than 1 cm to full dilation (approx 10 cm) to allow birth of a term fetus

Front 9

-what marks the end of the first stage of labor

Back 9

full cervical dilation

Front 10

-what can cause slow cervical dilation

Back 10

scaring from prior infection

Front 11

-Ferguson reflex:

Back 11

stretch receptors in the vagina release oxytocin that triggers the maternal urge to bear down

Front 12

-what has demonstrated prolonged length of labor for nulliparas

Back 12

epidural analgesia results in a slowing in the active phase of first stage labor and in the second stage

Front 13

Secondary powers
-as the presenting part reaches the pelvic floor, the contractions change in character and become

Back 13

expulsive

Front 14

Secondary -the laboring woman experiences an (voluntary or involuntary) urge to push

Back 14

involuntary

Front 15

-she uses secondary powers (bearing down efforts) to aid in

Back 15

expulsion of the fetus as she contracts her diaphragm and abdominal muscles and pushes

Front 16

-the bearing down efforts result in increased intra abdominal pressure that compresses the uterus on all sides and adds to

Back 16

the power of the expulsive forces

Front 17

-(primary or secondary powers) have no effect on cervical dilation

Back 17

secondary

Front 18

what stage is pushing effective?

Back 18

-research has shown the pushing in the second stage is more effective and the woman is less fatigued when she begins to push only after she has the urge to do rather than the beginning to push when she is fully dilated w/o an urge to do so

Front 19

-what 2 things have been associated with prolonged breath holding and forceful pushing efforts

Back 19

fetal hypoxia and acidosis

Front 20

-delayed pushing results in:

Back 20

-delayed pushing results in less fetal oxygen desaturation

Front 21

Position of the laboring woman

-frequent changes in position do what 3 things

Back 21

relieve fatigue,
increase comfort,
improve circulation

Front 22

Position of the laboring woman

-an upright position (walking, sitting, kneeling, squating) offers many advantages: (2)

Back 22

-improve cardiac output
-pressure on the maternal vessels is reduced and compression is prevented

Front 23

Position of the laboring woman

-if the woman wishes to lie down, a _____position is suggested

Back 23

lateral

Front 24

Position of the laboring woman

-the “all fours” (hands and knees) may be used to

Back 24

relieve backache

Front 25

Position of the laboring woman

-the predominant position for births is

Back 25

the Lithotomy position

Front 26

Position of the laboring woman

-kneeling or squatting does what to the uterus

Back 26

forward and aligns the fetus with the pelvic inlet and can facilitate the second stage of labor by increasing the pelvic outlet

Front 27

Position of the laboring woman

-_______ positions can be used by the woman to help rotate a fetus that is in a posterior position

Back 27

lateral

Front 28

Position of the laboring woman

-it can also be used when there is a need for less force to be used during bearing down (when there is a need to control the speed of a precipitate birth)

Back 28

lateral

Front 29

Position of the laboring woman

-what position is for women who have epidural analgesia are associated with reduced labor duration

Back 29

upright positions

Front 30

Onset of labor

_________produced by the normal fetal hypothalamus, pituitary, and adrenal cortex may contribute to the onset of labor

Back 30

hormones

Front 31

Onset of labor

what results in the strong, regular, rhythmic uterine contractions (3 things)

Back 31

-progressive uterine distention,

increasing intrauterine pressure,

aging of the placenta caused by increased concentrations of estrogen and prostaglandins as well as decreased progesterone levels

Front 32

Onset of labor

-fetal fibronectin (fFN)
what is it?
who is it used for?

Back 32

is a protein found in plasma and vaginal secretions of pregnant woman before the onset of labor

being used to predict the likelihood of preterm labor in women who are at increased risk for this complication including those woman with the twin gestations)

Front 33

Stages of labor

-1st stage:
when is it

Back 33

-considered to last from the onset of regular uterine contractions to full dilation of the cervix

Front 34

Stages of labor
-longest stage?

Back 34

-the first stage is much longer than the 2nd and 3rd combined

Front 35

Stages of labor
-full dilation may occur in how long for a multiparous pregnancies

Back 35

in less than 1 hour in some

Front 36

Stages of labor
-1st stage
-in first time pregnancy, complete dilation of the cervix can take how long?

Back 36

up to 20 hours

Front 37

Stages of labor
-there are 3 phases in the first stage

Back 37

-latent: there is more progress in effacement of the cervic and little increase in descent
-during the active and transition phase- there is more rapid dilation of the cervix and increase rate of
descent of the presenting part

Front 38

Stages of labor
-maternal prepreganancy overweight and obesity can cause the what part of labor to be longer

Back 38

active

Front 39

Stages of labor
-2nd stage, how long does it last?

Back 39

-lasts from the time the cervix is fully dilated to the birth of the fetus

Front 40

Stages of labor
-2nd stage

multiparous woman : nulliparous woman:

Back 40

-takes an average of 20 min for multiparous woman and 50 for a nulliparous woman

-labor up to 2 hours is normal

Front 41

Stages of labor
-2nd stage

what will prolong this stage?

Back 41

-epidural analgesia will likely prolong the second stage

Front 42

Stages of labor
-2nd stage of labor

-latent phase of second stage labor: begins when?

Back 42

about the time of complete dilation of the cervix when the contractions are weak or not noticeable and the woman is not feeling the urge to push , is resting, or is exerting only small bearing down efforts with contractions

Front 43

Stages of labor
-2nd stage of labor

-the active phase is a period when

Back 43

contractions resume, making strong bearing down effe0rts and the fetal station is advancing

Front 44

3rd stage of labor
-lasts when?


-duration?

Back 44

-from the birth of the fetus until the placenta is delivered

-the duration of the 3rd stage may be as short as 3-5 min, but up to 1 hour is normal

Front 45

3rd stage of labor
--the placenta normally separates when?

Back 45

with the 3rd or 4th strong uterine contraction after the infant has been born

Front 46

-risk for hemorrhage increases as the length of the ______ increases

Back 46

3rd stage

Front 47

4th stage of labor
-lasts how long?

Back 47

about 2 hours after delivery of the placenta

Front 48

4th stage of labor
--period of

Back 48

immediate recovery when homeostasis is reestablished

Front 49

4th stage of labor
--important period for

Back 49

observation for complications (like abnormal bleeding)

Front 50

Fetal lie,
-baby in relationship to moms line
-longitudinal or transverse??

Back 50

(transverse baby is not going to deliver easy vaginally) you want it longitudinal and head down is better

Front 51

Fetal position
1)
2)
3)

Back 51

-R or L (in relation to mom. You can feel the fontanels to see which way the baby is facing);

-S, O, M, or Sc we want O-occiput;

-A, P, or T (babies who are transverse will not deliver vaginally) when babies are coming down they do rotate and may spend some time transverse.

Front 52

Posterior or anterior kids, which way do we want them born?

Back 52

Posterior kids are born sunny side up (it’s harder for mom. Head is face up. We want the babies to look down at the floor.

Front 53

Passageway: birth canal

gynecoid

android

Back 53

gynecoid (50% of woman have this kind of pelvis),


android (heart shaped, likely to be c section or difficulty point)

Front 54

what labor position:
-the baby is OP.
-

Back 54

“All fours” position

The back of the babies head is on the moms spine. Gravity can help the baby turn or take the babies head off the moms spine.

Front 55

Signs preceding labor

Lightening -

Bloody show –

Back 55

Lightening -when the baby drops. Just means we are getting closer.


Bloody show –mucous plug disengaging. Doesn’t mean labor