Normal Labor And Birth

Front 1

Which U muscle layer is most responsive to Oxytocin

Back 1

Outer: longitudinal, circular, oblique, 2/3 whole thickness in upper 1/3 thickness in lower, 10% in cervix

Front 2

What are the 3 layers of U wall?

Back 2

Peritoneal, Myometrium, Endometrium

Front 3

What is a pregnant Endometrium called?

Back 3

Decidua

Front 4

What muscle layer of U makes up the sphincter of the cervix and fallopian tubes?

Back 4

Inner: longitudinal, oblique in circular/clockwise and counterclockwise

Front 5

What forms the physiological retraction ring?

Back 5

The two segments, upper and lower, meeting. The thickening and shortening upper and the lengthening and thinning lower

Front 6

What is the name of the pathologic ring?

Back 6

Bandels Ring, distended and tender lower U are the symptoms

Front 7

Where are U pacemakers in greatest conc?

Back 7

The cornua, the place of U Ctx initiation, travels up from the impulse site to funds, moves across and down the U

Front 8

Oxytocin's role in labor?

Back 8

Plays role in initiating ctx

Rises in 2nd stage, pulse frequency increases in labor, rises again immediate pp and breastfeeding

Secreted by pituitary

Front 9

Progesterone's role in labor?

Back 9

Relaxant affect on U smooth muscle to inhibit ctx, Pro Gest

Front 10

Prostaglandin's role in labor?

Back 10

Enhances action of oxytocin and cervical dilation, ripens cvx, relaxes cvx smooth muscle, help in formation of gap junctions, makes Ca more available and therefore lowers the threshold for muscle ctx

Front 11

Where are PGs made?

Back 11

The U makes until labor, the decidua

Front 12

Estrogen's role?

Back 12

promotes formation of gap junctions, increases O receptor sites on myometrium throughout preg and 2-3x at the onset of labor

Front 13

Adrenaline's role?

Back 13

Acts as breaks in labor

Front 14

Endophin's role?

Back 14

Block perception of pain, nature's opiates

Front 15

When do primips typically experience effacement?

Back 15

Before dilation

Front 16

What is the mechanism of effacement?

Back 16

shortening of cvx ultimately leaves only the external Os, lengthening of muscles around internal Os pulling up

Front 17

What is the mechanism of dilation?

Back 17

Presenting part forces open the external Os, Longitudinal muscles retract and cause the cvx to be incorporated into U, opens the external Os

Front 18

What are 4 sources of pain during the 1st stage of labor?

Back 18

Oxygen deprivation in contracted myometrium, compression of nerve gangia in cvx and lowere U during ctx, cvx stretching, traction, strechgin on fallopian tubes, pressure of sacrum, urethra, bladder, rectum, referred pain of and wall

Front 19

pain souces in 2nd stagw

Back 19

ring of fire

aching,burning, cramping in lower legs

indirect traction of U ligaments

Front 20

pain in 3rd stage

Back 20

pain in birth canal

pain from tears

cvx dilation as placenta goes through

Front 21

Pain overall effect on body systems in labro

Back 21

Boost catecholamine

increase heart rate, rhythm

hyperventialtion

vasocontriction

N/V

disrupt O2 balance, leads to fetal hypoxia

Front 22

What are some of the advantages of pain med free labor?

Back 22

causes endorphin release

helps her retreat to a safe area for labor and birth

Helps her orient her body to optimal positioning for moving the baby safely through birth canal

Unusually strong pain indicates a problem (can be missed with meds)

Front 23

How does anxiety increase pain or keep the gate open?

Back 23

Autonomic arousal of small fibers which increase the conductivity of messages

Front 24

4 basic components of standard precautions

Back 24

hand hygiene,

use of personal protective devices, gloves, gowns, masks

safe injection practices

respiratory hygiene

Front 25

How long can sterilized equipment be considered sterile?

Back 25

1 week

1 month

if +1 month, put pack in oven at house so sterile at time of birth

Front 26

Bake to sterilize?

Back 26

250 2 hrs

350 1 hr

or max pressure 25 min or boil 25 min

Front 27

How long is prodromal labor

in nulliparas? in multips?

Back 27

20 hrs

14 hrs

Front 28

How long are ctx in 2nd and 3rd stage

Back 28

60-90

Front 29

How frequent are ctx in 2nd and 3rd stage

Back 29

1.5 to 2 min

Front 30

Latent phase avg primips

Back 30

8.6 hrs

Front 31

Latent phase upper normal primips

Back 31

20 hrs

Front 32

Active phase avg primips

Back 32

5.8 hrs

Front 33

Active phase upper normal primips

Back 33

12 hrs

Front 34

First stage avg primps

Back 34

13.3 hrs

Front 35

First stage upper normal primps

Back 35

28.5 hrs

Front 36

Second stage avg primips

Back 36

57 min

Front 37

Second stage upper normal primips

Back 37

2.5 hr (epidural given extra hr)

Front 38

Rate cervical dilation during active phase

Back 38

< 1.2 cm/hr is abnormal

Front 39

latent phase avg multips

Back 39

5.3 hrs

Front 40

latent upper normal multips

Back 40

14 hrs

Front 41

active avg multips

Back 41

2.5 hrs

Front 42

active upper normal multips

Back 42

6 hrs

Front 43

second stage avg multips

Back 43

18 min

Front 44

second stage upper normal multips

Back 44

50 min

Front 45

cervical dilation

Back 45

under 1.5 cm/hr is abnormal

Front 46

Precipitous labor

Back 46

3 hrs

Front 47

prolonged latent phase primip

Back 47

exceeds 20 hrs

Front 48

prolonged multip latent phase

Back 48

exceeds 14 hrs

Front 49

prolonged active phase primip

Back 49

exceeds 12 hrs

Front 50

prolonged active phase multip

Back 50

exceeds 6 hrs

Front 51

primary dysfunctional labor, aka protracted active phase

Back 51

less than 1.2 cm/h

Front 52

secondary arrest dialation

Back 52

cessation of dilation > 2h

Front 53

arrested descent

Back 53

cessation of decent > 2h