Ob Ch 23 4 P's

Front 1

Define three main components of labor.

Back 1

1. Power = force that propels the fetus, uterine contractions.

2. Passenger = fetus

3. Passageway = birth canal

Front 2

What are the major assessments used to detect deviations from normal labor & birth?

Back 2

Fetal & uterine monitoring

Front 3

What are the types of abnormal uterine contractions?

Back 3

Hypotonic Uterin Contractions

Hypertonic Uterine Contractions

Uncoordinated Contractions

Front 4

What is the dysfunctional labor patterns for the first stage of labor?

Back 4

1. Prolonged latent phase

2. Prolonged deceleration phase

3. Protracted active phase

4. Secondary arrest of dilatation

Front 5

What are some common health problems associated with multiple gestation deliveries?

Back 5

1. Small-for-gestational age (SGA)

2. Cord prolapse

3. Cord compression

4. Intracranial hemorrhage

5. Abnormal fetal presentation

Front 6

What are the dangers of breech delivery?

Back 6

Dysfunctional labor
Early rupture of membranes
Higher risk of anoxia from prolapsed cord
Traumatic injury to the aftercoming head
Fracture of the spine or arm

Front 7

What are some types of abnormal presentation?

Back 7

Occipitoposterior position

Breech presentation

Face presentation

Brow presentation

Transverse lie

Front 8

What are the indications for a forceps delivery?

Back 8

Woman is unable to push with contractions.

Cessation of progress in the second stage of labor.

Fetus in abnormal position.

Fetus is immature.

Front 9

What are the two types of breech presentation?

Back 9

Complete

Frank

Double footing

Single footing

Front 10

What causes a marked caput on the newborn's head when used?

Back 10

Vacuum Extraction

Front 11

What is the immediate management of umbilical cord prolapse?

Back 11

Knee-chest position or Trendelenburg position.

Front 12

What is the terms used to describe a sluggish contraction?

Back 12

Inertia or Dysfunctional

Front 13

Amniotic Fluid Embolism
Augmentation of Labor
Battledore Placenta

Back 13

Amniotic Fluid Embolism = blockage in mom's blood vessel caused by passage of amniotic fluid into her bloodstream.

Augmentation of Labor = strengthening labor contractions

Battledore Placenta = placenta w/ umbilical cord on the periphery instead of center.

Front 14

Dysfunctional Labor
Dystocia
External Cephalic Version

Back 14

Dysfunctional Labor = slow labor because of ineffective contractions.

Dystocia = difficult delivery.

External Cephalic Version = rotating the baby into a cephalic lie by pushing on mom's abdomen.

Front 15

Forceps Birth
Hypertonic Uterin Contractions
Hypotonic Uterin Contraction

Back 15

Forceps Birth = use of forceps to take baby out.

Hypertonic Uterin Contractions = contractions that maintain a high resting tone.

Hypotonic Uterin Contraction = contractions that are infrequent & ineffective.

Front 16

Oxytocin
Pathologic retraction Ring
Precipitate Labor

Back 16

Oxytocin = secreted by posterior pituitary, maintain & strengthen uterin contractions.

Pathologic retraction Ring = indentation horizontally across the uterus - means extreme stress on the divisions of the organ.

Precipitate Labor = contractions so strong the woman delivers with only a few rapidly occurring contractions.

Front 17

Placenta Accreta
Placenta Circumvallata
Placenta Marginata
Placenta Succenturiata

Back 17

Placenta Accreta = abnormal adherence of the placenta to the uterine wall. makes placental delivery hard.

Placenta Circumvallata = placenta w/ fetal surface covered by chorion.

Placenta Marginata = placenta w/ edge of the fetal surface covered by chorion.

Placenta Succenturiata = placenta w/ one or more accessory lobes.

Front 18

Umbilical Cord Prolapse
Uterine Inversion
Vacuum Extraction

Back 18

Umbilical Cord Prolapse = umbilical cord that is presenting at the cervix prior to birth of baby.

Uterine Inversion = turning inside out of the uterus; could occur following childbirth from an action such as pulling on the umbilical cord before the placenta separates.

Vacuum Extraction = delivery of baby by suction applied to the presenting part.

Front 19

Precipitate Labor

Back 19

birth that is completed in less than 3 hrs. It can be responsible for subdural hemorrhage in the baby & cervical lacerations in the mom.

Front 20

Uterin Rupture

Back 20

Rare - usually preceded by pathologic retraction ring (shown by an indentation across the abdomen over the uterus).

Front 21

Uterine Inversion

Back 21

Grave complication - must be corrected immediately - emergency hysterectomy to save woman - can be avoided by two axims of care:
1. Do not put pressure on an uncontracted fundus immediately postpartum (massage first to cause it to contract).
2. Do not exert pressure on an umbilical cord to achieve placental delivery.

Front 22

Amniotic Fluid Embolism

Back 22

Emergency - mother will feel chest pain & dyspnea. Administer O2 & notify the woman's doc

Front 23

Prolapse of Umbilical Cord

Back 23

Emergency - position mom quickly into Trendelenburg/Knee-chest position to relieve cord compression, or apply manual pressure vaginally to lift the head away from the cord; Notify doc

Front 24

Criteria for Labor induction before preparing an Oxytocin Solution

Back 24

1. Engagement of the fetal head

2. a "ripe" cervix

3. Absence of cephalopelvic disproportion.

*Question an order if the above criteria are not present.

Front 25

What abnormalities of the placenta & cord can lead to birth complications?

Back 25

Placenta Succenturiata

Placenta Circumvallata

Battledore Placenta

Two-Vessel Cord