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24 Cards in this Set
- Front
- Back
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five p's that affect labor |
1) Passenger (fetus and placenta) 2) passageway (birth canal) 3)powers (contractions) 4) position of mother 5) psychologic response |
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Presentation |
the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor at term |
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three main presentations |
1) cephalic presentation (head first) 2) breech presentation (buttocks, feet or both first) 3) shoulder presentation |
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Factors that determine the presenting part of the fetus |
1) fetal lie 2) fetal attitude 3) extension or flexion of the fetal head |
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Fetal lie |
is the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother |
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Fetal attitude |
is the relation of the fetal body parts to one another. The fetus assumes a characteristic posture (attitude) in utero partly because of the mode of fetal growth and partly because of the way the fetus conforms to the shape of the uterine cavity. |
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general flexion |
is when the back of the fetus is rounded so the chin is flexed on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the knees. The arms are crossed over the thorax, and the umbilical cord lies between the arms and legs. |
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biparietal diameter |
is about 9.25 cm at term, is the largest transverse diameter and an important indicator of fetal head size. |
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fetal position |
is the relationship of a reference point on the presenting part (occiput, sacrum, mentum (chin), or sinciput (deflexed vertex) to the four quadrants of the mother's pelvis. |
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how is fetal position denoted? |
1) the first letter denotes the location of the presenting part in the right or left side of the mothers pelvis. 2) middle letter stands for the specific presenting part of fetus (O for occiput, S for sacrum, M for mentum (chin) and Sc for scapula 3) third letter stands for the location of the presenting part in relation to the anterior (A), posterior (P), or transverse (T) portion of mother's pelvis |
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Station |
the relationship of the presenting fetal part to an imaginary line drawn between the maternal ischial spines and is a measure of the degree of descent of the presenting part of the fetus through the birth canal. |
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Engagement |
the term used to indicate that the largest transverse diameter of the presenting part (usually the biparietal diameter) has passed through the maternal pelvic brim or inlet into the the true pelvis and usually corresponds to station 0. |
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The four basic types of the pelvis |
1)Gynecoid (the classic female type and the most common) 2) Android (resembling the male pelvis 3) anthropoid (resembling the pelvis of anthropoid apes) 4) Platypelloid (flat pelvis) |
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soft tissues of the passageway |
distensible lower uterine segment, the cervix, the pelvic floor muscles, the vagina, and the introitus. |
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primary powers |
involuntary contractions that move downward over the uterus in waves separated by short rest periods. Terms used to describe these include: frequency (the time from the beginning of one contraction to the beginning of another), duration (length of contraction), and intensity ( strength of contraction at its peak). |
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Effacement |
the shortening and thinning of the cervix during the first stage of labor. degree of effacement is expressed in percentages from 0%-100% |
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dilation |
of the cervix is the enlargement or widening of the cervical opening and the cervical canal that occurs once labor has begun. expressed by 1cm-10cm and full dilation marks the end of the first stage of labor. |
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ferguson reflex |
stretch receptors in the posterior vagina cause release of endogenous oxytocin that triggers the maternal urge to bear down. |
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secondary forces |
bearing down efforts to aid in the expulsion of the fetus as she contracts her diaphragm and abdominal muscles and pushes. This results in increased intrabdominal pressure that compresses the uterus on all sides and adds to the power of the expulsive forces. |
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signs preceding labor |
lightening, return of urinary frequency, backache, strainer braxton hicks contractions, weight loss of 0.5 to 1.5 kg, surge of energy, increased vaginal discharge-bloody show, cervical ripening, and possible rupture of membranes. |
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bloody show |
brownish or blood tinged cervical mucus may be passed preceding labor |
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descent |
the progress of the presenting part through the pelvis. depends on four forces: pressure exerted by the amniotic fluid, direct pressure exerted by the contracting fundus on the fetus, force of the contraction of the maternal diaphragm and abdominal muscles in the second stage of labor, and the extension and straightening of the fetal body. |
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fetal respiration changes during labor |
-fetal lung fluid is cleared from the air passages as the infant passes through the birth canal during labor -fetal oxygen pressure decreases -arterial carbon dioxide pressure increases - arterial pH decreases -bicarbonate level decreases - fetal respiratory movements decrease during labor |
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maternal changes during labor |
-Cardiac output increases 10%-15% in first stage; 30%-50% in the second stage -HR increases slightly in 1st and 2nd stages systolic bp increases during uterine contractions in first stage; systolic and diastolic pressures increase during uterine contractions in 2nd stage - WBC increases -RR increases -temp maybe slightly elevated -proteinuria may occur -gastic motility and absorption of solid food decreases; N/V may occur during transition to 2nd stage labor -BG level decreases |
