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41 Cards in this Set
- Front
- Back
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Antepartum |
Period of pregnancy before labour and delivery |
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Postpartum |
Period shortly after childbirth |
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Gravida |
Number of pregnancy (including still births and miscarriages) that a woman has |
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Parity |
Number of live births that a woman has delivered |
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Gestational period |
When an embryo develops (around 262 days) |
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First trimester |
First day of the last period through to 12 week of gestation |
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Second trimester |
13th-27th week of gestation |
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Third trimester |
28th week of gestation until delivery |
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Singleton |
Single fetus |
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Multiparous |
Having two or more offsprings at one birth |
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Vernix casesosa |
Layer of greasy material that covers the fetus |
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Surfactant |
Prevent air sacs of the lungs from collapsing |
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Assessment of the obstetric patient SAMPLE |
How many weeks? Due date, need to ascertain gravida and parity, previous obstetric history especially in relation to birthing problems and/or premature births, has patient had antental care and/or recent scan, enquire about fetal movement |
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Assessment of the obstetric patient VSS |
Ask about bleeding, discharge or 'shows (cervix dilating) depending on presenting problem |
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Assessment of the obstetric patient OPQRST |
- Pain (contractions) such as length of contractions and time between episodes - Pain location - If previous delivery, inquire about similarities |
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Aortocaval compression |
Need to position all pregnant patient on the left lateral position with hips elevated. - Displaces the fetus so compression of blood vessels are minimised - Left positioning preferred as it provides less pressure on vena cava - aorta able to compensate better due to intrinsic higher pressure |
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Cardiac arrest |
- Aortocaval compression an issue in this setting - Cardiac output already reduced - Any intrinsic factor which causes a reduction in CO and blood returning to heart will have detrimental effects |
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First stage of labour |
- Phase last around 10-12 hours on average - Onset of regular rhythmic, explusive contractions to full dilation of cervix - Initial contractions 15-30 minutes apart lasting 10-30 secs - Signs includes: show, breaking of waters, true labour pains |
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Second stage of labour |
- Expulsive uterine contractions - Fresh show of blood - Rupture of membranes - Anus protusion or anal scarring - Tension between the coccyx and the anus - Vulva gapping - Bulging of the perineum - Appearance of the presenting part |
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Third stage of labour |
- Delivery of placenta - Fresh show of blood - Firmly contracting uterus - Lengthening of the cord |
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Signs of imminent birth |
- Crowning has occurred - Contractions are 2 mins apart or closer lasting for 60-90 secs - Patient can feel head moving down birth canal - Strong urge to defecate - Strong urge to push - Abdomen is hard |
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Eight stages of second stage labour |
1. Engagement 2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. Restitution 7. External rotation 8. Explusion |
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Engagement |
When the widest part of the head enters the pelvic inlet |
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Descent |
Head enters the pelvis in a transverse position to conform with shape of the pelvic inlet |
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Flexion |
- Head descends and it counters resistance from the muscle of the pelvic floor - Flexion allows the smallest diameter of the head to move through the pelvis |
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Internal rotation |
- Midpelvis is widest from front to back - Fetus rotates to face the mother's sacrum - Only the head makes this turn - Shoulders remain oblique |
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Extension |
- Back of head reaches the pubic bone and pivot beneath it - Head extends to follow the direction of the vagina - Will see perianal bulging, crowning and then birth of head |
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Restitution |
- Baby's head is born, it faces the anus - Shoulders remain positioned diagonally - Baby's head turn to the left or right to realign with shoulders |
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External rotation |
Head turns further to the side as the shoulder rotate internally
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Expulsion |
- Anterior shoulders slide under the pubic bone and is born by lateral flexion - Posterior shoulder is born - Body follows - Newborns are slippery |
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To push or not |
- encourage mother to only push when presenting part appears - do not push between contractions - encourage to pant not push during crowning |
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Complications during the second stage |
- Precipitous delivery (short labour): assist mother to prevent injury - Intact membranes: tear membrane - Rapid delivery of head: support head - Prolapsed cord: umbilical cord comes out before baby - Shoulder dystocia |
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Management of placenta |
- Allow placenta to delivery naturally - Apply gentle cord traction with counter pressure on fundus - can take up to an hour - when placenta delivers bag for examination |
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Complications during third stage |
- Retain placenta - Uterine inversion (prolapse) and rupture - Amniotic fluid embolism - Primary postpartum haemorrhage (normal blood loss from delivery is around 500mls) |
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Routine care for newborn |
- Assess - Dry baby - Conserve body warmth - Clear airway as required - Complete APGAR score - Try to get baby to suckle
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Meconium aspiration |
- The first stool passed by the neonate - Can present as light brown/yellowish-green when mixed with amniotic fluid - Meconium aspiration is rate - Usually happens in term infants and before delivery |
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Meconium aspiration treatment |
- Suction the nose and mouth on presentation of the head during delivery - After neonate delivered then re-suction and resuscitate as necessary
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Factors which initiate respiration |
- Change in blood gas levels (increase PaO2 and decrease in PaCO2) - Cold stimulus of the change in temperature - Swallowing - Chest compressions
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Stimulating neonate to breath |
- Drying - Gently flicking the soles of feet - Massaging back |
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APGAR |
appearance, pulse(>100 beats), grimace, activity, respiration (good and crying) |
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Clamping and cutting the cord |
- Cord is clamped after it stop pulsating - Clamped at 10cm, 15cm and 20cm - Cut between 15 and 20 |
