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31 Cards in this Set
- Front
- Back
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What is false labor? |
1. Irregular, brief contractions 2. Pain in groin or lower abdomen 3. No cervical change 4. Contractions stop when patient lays down |
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What is labor? |
1. Regular contractions which cause the progressive dilation of the cervix and subsequent expulsion of the fetus |
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When should you admit a gravid woman to the hospital? |
1. Contractions every 3-5 minutes for at least 40 s 2. Cervix dilated to 3 3. 50% effaced 4. Ruptured membranes |
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What is stage I labor? |
1. Cervical effacement and dilation 2. Begins with contractions causing cervical dilation 3. Ends with fully dilated cervix 4. 2 phases-- latent and active |
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What is latent phase labor? |
1. Precedes active labor by several hours 2. Contractions are uncomfortable and regular 3. Slow cervical effacement and dilation 4. Typically ends at 3-5 cm |
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What is active phase labor? |
1. Starts at 3-5 cm after latent phase is complete 2. Phase is characterized by more intense contractions and more rapid and consistent cervical dilation |
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How do you monitor labor? |
1. Sterile vaginal exams to assess cervical dilation, effacement, station, and membranes 2. Assess frequency and duration of contractions 3. Assess fetal tolerance to labor 4. Chart Friedman's labor curve for progress |
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How often should cervical exams be done in labor? |
1. Every 2 hours |
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What is 0 station? |
1. Fetal vertex at ischial spines |
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When should fetal heart tones be obtained in a low risk pregnancy? |
1. First stage-- FHTs obtained at least every 30 minutes after a contraction 2. Second stage-- obtained at least every 15 minutes after a contraction |
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When should FHTs be obtained in a high-risk pregnancy? |
1. First stage-- obtained at least every 15 minutes after a contraction 2. Second stage-- obtained at least every 5 minutes after a contraction |
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What is the genes of pain during labor? |
1. Visceral sensory fibers for the uterus and cervix and transmitted to T11 and T12 via Frankenhauser ganglion 2. Then transmitted to pelvic plexus and internal iliac plexus 3. Pudendal nerve provides sensation to lower genital tract |
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What nerve is responsible for sensing pain as labor progresses? What fibers make it up? |
1. Pudendal 2. S2-S4 |
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What types of regional anesthetics are available for pain control during labor? |
1. Epidural 2. Intrathecal 3. Pudendal block |
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What is stage II labor? |
1. Stage of expulsion of fetus 2. Begins with complete cervical dilation 3. Ends with delivery of infant |
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When can a patient begin to push in labor? |
1. Stage II |
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What can occur if a patient pushes prior to maximal cervical dilation? |
1. Ineffective 2. Maternal exhaustion 3. Cervical edema |
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When does the timing of FHTs change? |
1. Stage II labors |
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Where is an episiotomy performed? |
1. Perineal body where the bulbospongiosus and superficial transverse perineal muscles attach |
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What are the risks of episiotomy? |
1. Increased risk of 3rd and 4th degree lacerations |
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What is stage III labor? |
1. Stage of placental separation and expulsion 2. Begins with delivery of infant 3. Ends with delivery of placenta and fetal membranes |
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What are the sings of placental separation? |
1. Uterus rises in the abdomen and becomes globular 2. Umbilical cord lengthens 3. Gush of blood |
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When is the third stage of labor considered 'prolonged'? What is the associated risk? |
1. More than 30 minutes have elapsed between time of delivery of fetus and delivery of placenta 2. Increased risk of postpartum hemorrhage |
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What should you do after delivering the placenta? |
1. Inspect lower GU tract and cervix for obstetric laceration 2. Examine the placenta to ensure it is intact-- 3 vessel cord
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What is a first degree laceration? |
1. Involves vaginal epithelium and/or perineal skin 2. No muscle tissue
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What is a second degree laceration? |
1. 1st degree plus subq and muscle tissue 2. Not extending into the anal sphincter or rectal mucosa |
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What is a third degree laceration? |
1. 2nd degree plus external anal sphincter |
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What is a fourth degree laceration? |
1. 3rd degree including rectal mucosa |
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What increase the risk of obstetric lacerations? |
1. Nulliparity 2. Prolonged second stage of labor 3. Occiput posterior 4. Forceps use 5. Ethnicity 6. Episiotomy
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What is the morbidity associated with obstetric laceration? |
1. Worsens as lacerations worsens |
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What is the fourth stage of labor? |
1. 1st 2 hours after the delivery of the placenta 2. Physiologic changes are occurring 3. Mother at high-risk for postpartum complications |
