Ob- Normal Labor Key Terms

Front 1

oblique presentation of the fetal head at the superior strait of the pelvis; the pelvic planes and those of the fetal head are not parallel

Back 1

asynclitism

Front 2

relation of fetal parts to each other in the uterus (e.g. all parts flexed, except neck extended)

Back 2

attitude

Front 3

largest transverse diameter of the fetal head; measured between the parietal bones

Back 3

biparietal diameter

Front 4

vaginal discharge that originates in the cervix and consists of blood and mucus; increases as cervix dilates during labor

Back 4

bloody show

Front 5

stretcing of the external os from an opening a few millimeters in size to an opening large enough to allow the passage of the fetus

Back 5

dilation

Front 6

thinning and shortening or bliteration of the cervix that occurs during late pregnancy or labor or both

Back 6

effacement

Front 7

in obstetrics, the entrance of the fetal presenting part into the superior pelvic strait and the beginning of the descent through the pelvic canal

Back 7

engagement

Front 8

reflex contractions (urge to push) of the uterus after stimulation of the cervix

Back 8

ferguson reflex

Front 9

broad areas, or soft spots, consising of a strong band of connective tissue contigous with cranial bones and located at the junctions of the bones

Back 9

fontanels

Front 10

relationship existing between the long axis of the fetus and the long axis of the mother; in a longitudinal, the fetus is lying lengthwise or vertically, wheras in transverse, the fetus is lying crosswise or horizontally in the uterus

Back 10

lie

Front 11

sensation of decreased abdominal distention produced by uterine descent into the pelvic cavity as the fetal presenting part settles into the pelvis; usually occurs 2 weeks before the onset of labor in nulliparas

Back 11

lightening

Front 12

overlapping of cranial bones or shaping of t he fetal head to accommodate and conform to the bony and soft parts of the mother's birth cancl during labor.

Back 12

molding

Front 13

relationship of a reference point on the presenting part of the fetus, such as the occiput, sacrum, chin, or scapula, to its location in the front, back, or sides of the maternal pelvis

Back 13

position

Front 14

that part of the fetus that first enters the pelvis and lies over the inlet; may be head, fae, breech, or shoulder

Back 14

presentation

Front 15

that part of the fetus that lies closest to the internal os of the cervix

Back 15

presenting part

Front 16

relationship of the presenting fetal part to an imaginary line drawn between the ischial spinse of the pelvis

Back 16

station

Front 17

smallest diameter of the fetal head; follows a line drawn from the middle of the anterior fontanel to the undersurface of the occipital bone

Back 17

suboccipitobregmatic diameter

Front 18

any forced expiratory effort against a closed airway, such as holding one's breath and tightening hte abdominal muscles (e.g. pushing during the second stage of labor)

Back 18

valsalva maneuver

Front 19

crown, or top, of the head

Back 19

vertex

Front 20

absence of pain without loss of consciousness

Back 20

analgesia

Front 21

partial or complete absence of sensation with or without loss of consciousness

Back 21

anesthesia

Front 22

husband-coached childbirth preparation method using labor breathing techniques and environmental modification

Back 22

bradley method

Front 23

pressure applied to the sacral ara of the back during uterine contractions

Back 23

counterpressure

Front 24

a prepared childbirth approach based on the premise that fear of pain produces muscular tension, producing pain and greater fear; includes teaching physiologic process of labor, exercise to improve muscle tone, and techniques to assist in relaxation and prevent the fear-tension-pain mechanism

Back 24

Dick-Read method

Front 25

gentle striking used in massage, usually on the abdomen

Back 25

effleurage

Front 26

type of regional anesthesia produced by injection of a local anesthetic alone or in combination with a narcotic analgesic into the epidural (peridural) space

Back 26

epidural block

Front 27

a patch formed by a few milliliters of the mother's blood occluding a tear in the dura mater around the spinal cord that occurs during induction of spinal block; its putpose is to relieve headache associated with leakage of spinal fluid

Back 27

epidural blood patch

Front 28

pain theory used to explain the neurophysiologic mechanism underlying the perception of pain: the capacity of nerce pathways to transmit pain is reduced or completely blocked by using distraction techniques

Back 28

gate-control- theory of pain

Front 29

childbirth preparation mehtod developed in the 1950s. Requires practiced at home and coaching during labor and birth; goals are to minimize fear and the perception of pain and to promote positive family relationships by using both mental and physical preparation, including breathing and relaxation techniques, effleurage, and focusing

Back 29

Lamaze

Front 30

process by which a substance such as a local anesthetic medication is deposited within the tissue to anesthetize a limited region of the body

Back 30

local perianeal infiltration anesthesia

Front 31

central nervous system depression in the newborn caused by an opioid (narcotic)- may be signaled by respiratory depression, hypotonia, lethargy, and delay in temperature regulation

Back 31

neonatal narcosis

Front 32

medications that relieve pain by activiating opioid receptors

Back 32

opioid (narcotic) agonist analgesics

Front 33

medications that combine agonist activity (activates or stimulates a receptor to perform a function) and antagonist activity (blocks a receptor or medication designed to activate a receptor) to relieve pain without causing significant maternal or fetal or newborn respiratory depression

Back 33

opioid (narcotic) agonist-antagonist analgesics

Front 34

medications used to reverse CNS depressant effects of an opioid, especially respiratory depression

Back 34

opoid (narcotic) antagonists

Front 35

injection of a local anesthetic at the pudendal nerve root to produce numbness of the genital and perianal region

Back 35

pudendal nerve block

Front 36

regional anesthesia induced by injection of a local anesthetic ageint into the subarachnoid space at the level of the third, fourth, or fifth lumbar interspace

Back 36

spinal anesthesia (block)

Front 37

pain relief induced when an analgesic is administered parenterally (e.g. subcutaneous, intramuscular, or intravenous route) and crosses the blood-brain barrier to provide central analgesic effects

Back 37

systemic analgesia

Front 38

central nervous system depression in the newborn caused by an opioid (narcotic)- may be signaled by respiratory depression, hypotonia, lethargy, and delay in temperature regulation

Back 38

neonatal narcosis

Front 39

medications that relieve pain by activiating opioid receptors

Back 39

opioid (narcotic) agonist analgesics

Front 40

medications that combine agonist activity (activates or stimulates a receptor to perform a function) and antagonist activity (blocks a receptor or medication designed to activate a receptor) to relieve pain without causing significant maternal or fetal or newborn respiratory depression

Back 40

opioid (narcotic) agonist-antagonist analgesics

Front 41

medications used to reverse CNS depressant effects of an opioid, especially respiratory depression

Back 41

opoid (narcotic) antagonists

Front 42

injection of a local anesthetic at the pudendal nerve root to produce numbness of the genital and perianal region

Back 42

pudendal nerve block

Front 43

regional anesthesia induced by injection of a local anesthetic ageint into the subarachnoid space at the level of the third, fourth, or fifth lumbar interspace

Back 43

spinal anesthesia (block)

Front 44

pain relief induced when an analgesic is administered parenterally (e.g. subcutaneous, intramuscular, or intravenous route) and crosses the blood-brain barrier to provide central analgesic effects

Back 44

systemic analgesia

Front 45

increase in fetal heart rate (FHR); usually interpreted as a reassuring sign

Back 45

acceleration

Front 46

infusion of normal saline warmed to body temperature through an intrauterine catheter into the uterine cavity in an attempt to increase the fluid around the umbilical cord and prevent compression during uterine contractions

Back 46

amniofusion

Front 47

average FHR during a 10-minute period that excludes periodic and episodic changes and periods of marked variability

Back 47

baseilne fetal heart rate

Front 48

baseline fetal heart rate below _____ beats per minute is considered bradycardia

Back 48

110

Front 49

slowing of FHR attributed to a parasympathetic response and described in relation to uterine contractions. Types include early, late, and variable

Back 49

deceleration

Front 50

a visually apparent gradual decrease of FHR before the peak of a contraction and return to baseline as the contration ends; caused by fetal head compression

Back 50

early deceleration

Front 51

a visually apparent gradual decrease of FHR with the lowest point of the deceleration occuring after the peak of the contraction and returning to baseline after the contraction ends; caused by uteroplacental insufficiency

Back 51

late deceleration

Front 52

a visually abrupt decrease in FHR below the baseline occurring any time during the uterine contracting phase and caused by compression of the umbilical cord

Back 52

variable deceleration

Front 53

electronic surveillance of FHR by external and internal methods

Back 53

electronic fetal monitoring (EFM)

Front 54

changes from baseline patterns in the FHR that are not associated with uterine contractions

Back 54

episodic changes

Front 55

changes from baseline patterns in the FHR that are not associated with uterine contractions

Back 55

episodic changes

Front 56

reduction in arterial PO2 resulting in metabolic acidosis by forcing anaerobic glcolysis, pulmonary vasoconstriciton, and direct cellular damage

Back 56

hypoxemia

Front 57

insufficient availability of oxygen to meet the metabolic needs of body tissue

Back 57

hypoxia

Front 58

listening to fetal heart sounds at periodic intervals using nonelectronic or ultrasound devices placed on the maternal abdomen

Back 58

intermittent auscultation

Front 59

FHR patterns that indicated the fetus is not well oxytenated and requires intervention

Back 59

nonreassuring FHR patterns

Front 60

changes from baseline of the fetal heart rate that occur with uterine contractions

Back 60

periodic changes

Front 61

baseline FHR above____ bpm is considered tachycardia

Back 61

160

Front 62

inhibition of uterine contractions thorugh administration of medications; used as an adjunct to other interventions in the managment of fetal compromise related to increased uterine activity

Back 62

tocolysis

Front 63

decline in placental function (exchange of gases, nutrients, and wastes) leading to fetal hypoxia and acidosis; evidenced by late FHR decelerations in response to uterine contractions

Back 63

uteroplacental insufficiency

Front 64

normal irregularity of fetal cardiac rhythm or fluctuations from the baseline FHR or two cycles or more

Back 64

variability

Front 65

phase in the first stage of labor when the cervix dilates from 4 to 7 cm

Back 65

active phase

Front 66

artificial rupture of the fetal membranes (AROM), using a plastic amniohook or surgical clamp

Back 66

amniotomy

Front 67

blood-tinged mucoid vaginal discharge that originates in the cervix and indicates passaage of the mucous plug (operculum) as the cervix ripens before labor and dilates during labor; it increases as labor progresses

Back 67

bloody or pink show

Front 68

phase in the descent of the fetus when the top of the head can be seen at the vaginal orifice as the widest part of the ehad (biparietal diameter) distends the vulva just before birth

Back 68

crowning

Front 69

experienced female assistant hired to give the woman support during labor and birth

Back 69

doula

Front 70

surgical incision of the perineum at the end of the second stage of labor to facilitate birth and to avoid laceration of the perineum

Back 70

episiotomy

Front 71

the appearance of a fernlike pattern found in microscopic examination of certain fluids such as amniotic fluid

Back 71

fern test

Front 72

stage of labor from the onset of regular uterine contractions to full effacement and dilation of the cervix

Back 72

first stage of labor

Front 73

phase in the first stage of labor when the cervix dilates from 0 to 3 cm

Back 73

latent phase

Front 74

four maneuvers for diagnosing the fetal position by external palpation of the mother's abdomen

Back 74

leopold maneuvers

Front 75

position in which the woman lies on her back with her knees flexed and with abducted thichs drawn up toward her chest; stirrups attached to an examination table can be used to facilitate assuming and maintaining this position

Back 75

lithotomy position

Front 76

evaluation of body fluids using a test strip to determing the fluid's pH; urine will exhibit an _____ result, and amniotic fluid will exhibit a _____ result.

Back 76

nitrazine test

acidic

alkaline

Front 77

encircling of fetal neck by one or more lops of umbilical cord

Back 77

nuchal cord

Front 78

technique used to control the birth of the head; upward pressure from the coccygeal region to extend the head during the actual birth

Back 78

ritgen maneuver

Front 79

integrity of the amniotic membranes is broken either spontaneously or artificially (amniotomy)

Back 79

rupture of membranes (ROM)

Front 80

stage of labor from full dilation of the cervix to birth of the baby

Back 80

second stage of labor

Front 81

rupture of membranes by natural means, most often during labor

Back 81

spontaneous rupture of membranes (SROM)

Front 82

stange of labor from the birth of the baby to the separation and expulsion of the placenta

Back 82

third stage of labor

Front 83

phase in the first stage of labor when the cervix dilates from 8 to 10 cm

Back 83

transition phase

Front 84

primary powers of labor that act involuntarily to dilate and efface the cervix, expel the fetus, facilitate separation of the placenta, and prevent hemorrhage

Back 84

uterine contractions