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27 Cards in this Set
- Front
- Back
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Describe the Quiescence phase of labor
What hormones are involved? |
Quiescence- time in utero before labor begins, uterine activity is suppressed
hormones involved- progesterone, prostacyclin, relaxin, NO, PTH |
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Describe the Activation phase of labor
What hormones are involved? |
Active- estrogen causes expression of myometrial PG & oxytocin receptors--> ion channel activation & inc gap junctions for effective contractions
hormones involved- estrogen, PG, oxytocin |
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Describe the Uterine Involution phase
What hormone is involved |
Uterine involution- occurs after delivery, uterus shrinks & bleeding stops
hormone: oxytocin |
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How are contractions quantified?
what is normal? What is tachysystole? |
# of contractions/ 10 minutes, avg over 30 mins
normal= 5 or less / 10 mins
tachysystole= more than 5/ 10 mins |
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What 3 things (P's) are necessary for successful delivery? |
-Power (contractions) -Passenger (baby size) -Passage (pelvic expansion- relaxin) |
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If a baby presents __________ the mother likely needs a c-section |
breech- head up in uterine fundus & buttock in the pelvis |
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There are 4 stages of labor. What is the 1st stage?
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2 phases of first stage (start of contractions to 10 cm)
a. latent phase= onset of contractions to cervix dilated 4 cm b. active= cervix dilated 4 cm to 10 cm
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How long does the 1st stage take?
What is the rate of cervical dilation during the active phase? |
1st stage- primigravida: 6 - 18 hrs multipara: 2-10 hrs
rate- primigravida: 1 cm/hr multipara: 1.5 cm/ hr |
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What is the 2nd stage?
How long does it take? |
Mother feels desire to push after contractions--> delivers baby
primigravida: 30 min- 3 hrs multiparous: 5- 30 mins |
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What is the 3rd stage?
How long does it take? |
Delivery of placenta (can inspect vagina for bleeding & lacerations)
0-30 mins
***NEVER takes longer than 30 mins |
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What is the 4th stage?
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observation after delivery for signs of bleeding (postpartum) |
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What is Friedman's labor curve used for? |
Used to tell if labor is progressing at a normal rate |
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What are the cardinal fetal movements that occur during labor? |
-engagement -flexion -descent -internal rotation -extension -external rotation -expulsion |
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___________ refers to passage of the widest diameter of the presenting part (head) to a level below the plane of the pelvic inlet |
Engagement |
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_________ of the fetal head occurs passively as the head descends owing to the shape of the bony pelvis & the resistance offered by the soft tissue of the pelvic floor |
Flexion |
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_______ refers to the downward passage of the presenting part through the pelvis |
Descent |
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__________ refers to anterioposterior rotation of the presenting part as it enters the pelvic inlet & passes through pelvis |
Internal rotation |
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___________ occurs once the fetus has descended to the level of the introitus |
Extension |
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___________ or restitution, is the return of the fetal head to the correct anatomic position in relation to the fetal torso |
External rotation |
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__________ delivery of the rest of the fetus |
Expulsion |
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Normal fetal heart rate (FHR) |
110 - 160 bpm
(variation is normal w movement) |
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What does early deceleration (gradual decrease in FHR w/ onset of deceleration to nadir >/= 30 seconds, nadir occurs at peak of contraction) represent? |
fetal head compression |
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What does variable deceleration (abrupt decrease in FHR w/ onset of deceleration to nadir < 30 seconds, deceleration lasts > 15 secs & < 2 mins) represent? |
cord compression |
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What does late deceleration (gradual decrease in FHR w/ onset of deceleration to nadir >/= 30 seconds. Onset of deceleration occurs after contraction begins & nadir occurs after peak) represent? |
placental insufficiency |
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Maternal indications for C-section |
cardiac disease (marfan's, CAD) respiratory disease (Guillian-Barre syndrome) increased intracrainal pressure uterine obstruction (tumor, fibroids) vulvular obstruction (condylomata)
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Maternal-fetal indications for C-Section |
cephalopelvic disproportion (head can't fit) placental abruption placenta previa elective C-section |
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Fetal indications for C-Section |
nonreassuring fetal status breech or transverse lie maternal herpes congenital anomalies |
