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18 Cards in this Set
- Front
- Back
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normal labor: definition
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onset of regular, painful contractions assoc'd w/cervical effacement and dilatation
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two phases of first stage of labor
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1. latent
2. active |
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spurious labor
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uterine contractions which may be regular and/or painful but NOT assoc'd w/cervical effacement and dilatation
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What are "the membranes"?
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fused chorion and amnion
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Why would you artificially rupture the membranes?
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to observe the volume and color of amniotic fluid or induce/augment the progress of labor (due to PG release)
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functions of contractions
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cerival dilation and effacement
push fetus through the birth canal |
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the 3 P's
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power
(contraction strong, long, and frequent enough) passenger (size, lie, presentation, attitude, position, station, number of fetuses) passage (bony pelvis and soft tissues of birth canal) |
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observations of mother during labor
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inf'n?
check pulse, temp, vaginal loss pre-eclampsia: check BP, urinalysis IPH check pulse, BP, vaginal loss emotional well-being eg. pain control |
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pain relief in labor
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non-pharm:
massage, relaxation/breathing techniques, position change, hot/cold packs, TENS -transcutaneous electrical nerve stimulant (electrode stimualation on back distracting from pain) pharm: inhalational agents - nitrous oxide systemic analgesics - opioids neuraxial analgesia local - pudendal nerve block, perineal infiltration |
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fetal well-being in labor
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ausculation of fetal heart
(every 15 minutes in active phase of S1 and after every contraction in S2) continuous electronic fetal monitoring (CTG) amt and color of amniotic fluid |
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maternal evaluation on admission
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review antenatal Hx
labor Hx (duration of labor, show, ROM, bleeding, FM) antenatal education, birth/analgesia plan examination (pre-eclampsia, inf'n, bleeding, contraction character, pain control) |
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What is the progress of labor recorded on?
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a partogram
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How does the head negotiate the pelvis?
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moulding (changes shape)
flexion (changes size) position (rotation) |
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How does head get out of normal delivery?
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1. Descent
2. Flexion 3. Internal rotation (to OA) 4. Extension 5. External rotation (head restitutes - allows shoulders to present to greatest pelvic diameter [AP]) |
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How to hold baby to prevent dropping?
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hold baby by neck and feet
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signs of placental separation
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fresh show of blood PV
lengthening of cord uterus becomes firm |
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PPH mantra
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An empty, intact, contracted uterus will not bleed unless there is a coagulopathy or the uterus is inverted.
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components of active Mx of S3
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prophylactic admin of oxytocic
controlled cord traction early cord clamping |
