Maternity Chapter 8

Front 1

Amniotomy

Back 1

The artificial rupture of membranes (arom) (amniotic sac) by using a sterile sharp instrument to puncture the amniotic sac and release the amniotic fluid for the purpose of inducing or augmenting labor.

Front 2

Induction of labor

Back 2

The intentional initiation of labor before it begins naturally.

Front 3

Augmentation of labor

Back 3

The stimulation of contractions after they have begun naturally.

Front 4

Bishop score

Back 4

Used to assess the status of the cervix in determining its response to induction

Front 5

When is labor induced?

Back 5

If continuing the pregnancy is hazardous for the woman or the fetus

Front 6

Name 4 indicators for labor induction

Back 6

Gestational hypertension

Ruptured membranes without spontaneous onset of labor

Infection within the uterus

Medical problems in the woman that worsen during pregnancy ( diabetes, kidney disease, pulmonary disease)

Front 7

Amnioinfusions

Back 7

The injection of warmed sterile saline or lactated Ringer’s solution into the uterus via an intrauterine pressure catheter during labor after the membranes have ruptured.

Front 8

Indicators for an amnioinfusion

Back 8

Oligohydramnios

Umbilical cord compression resulting from lack of amniotic fluid

Goal of reducing variable decelerations

Goal of diluting meconium stained amniotic fluid to prevent meconium aspiration syndrome

Front 9

Oligohydraminos

Back 9

Lower than normal amount of amniotic fluid

Front 10

Nonpharmacologic methods to stimulate contractions

Back 10

Complementary and alternative medicine (CAM)

Walking

Nipple stimulation of labor

Front 11

Pharmacological and mechanical methods to stimulate contractions

Back 11

Pharmacological: Prostaglandin E2 Dinoprostone (cervidil)

Prostaglandin E1 misoprostol

Mechanical: stripping the amniotic membranes

Hydroscopic dilators

Transcervical balloon dilators

Front 12

Version

Back 12

Method of changing the fetal presentation usually from breech or oblique, to cephalic. There are two methods internal and external, external is more common.

Front 13

External version

Back 13

Performed after 37 weeks but before onset of labor. Procedure begins with a NST or biophysical profile to determine adequate amts of amniotic fluid and that the fetus is in good condition. Woman receives tocolytic drug to relax uterus. Using ultrasound the physician pushed the fetal buttocks upward out of the pelvis while pushing the fetal head downwards toward the pelvis.

Front 14

First degree

Back 14

Involves the superficial vaginal mucosa or perineal skin

Front 15

Second degree

Back 15

Involves the vaginal mucosa, perineal skin, and deeper tissues of the perineum.

Front 16

Third degree

Back 16

Same as second degree, plus involves the anal sphincter

Front 17

Fourth degree

Back 17

Extends through the anal sphincter into the rectal mucosa

Front 18

Midline episiotomy

Back 18

Extending directly from the lower vaginal border toward the anus

Front 19

Mediolateral episiotomy

Back 19

Extending from the lower vaginal border toward the mother’s right or left side.

Front 20

Forceps and vacuum extraction

Back 20

An OB used these tools to provide traction and rotation to the fetal head when the mothers pushing efforts are insufficient to accomplish a safe delivery.

Front 21

Forceps

Back 21

Instruments with curved blades that fit around the fetal head without unduly compressing it

Front 22

Vaccum extractor

Back 22

Used suction applied to the fetal head so that the healthcare provider can assist the mother’s expulsion efforts.

Front 23

What are the three types of uterine incisions?

Back 23

Low transverse incisions- preferred because it is not likely to rupture during another birth, causes less blood loss, and is easier to repair.

Low vertical incision- produces minimal blood loss and allows delivery of a larger fetus, more likely to rupture during another birth.

Classic incision- rarely used because it involves more blood loss, and is most likely of the 3 incisions to rupture during another pregnancy.

Front 24

Abnormal labor

Back 24

Aka dysfunctional labor and is when labor does not progress.

Dystopia a term used to describe a difficult labor.

Abnormalities in the powers, passengers, passage, or psyche may result in dysfunctional labor.

Front 25

Risk factors for dysfunctional labor include...

Back 25

Advanced maternal age

Obesity

Overdistention of uterus

Abnormal presentation

Overstimulation of uterus

Maternal fatigue

Lack of analgesic assistance

Front 26

Increased uterine muscle tone

Back 26

Usually occurs during the latent phase of labor (before 4cm of cervical dilation) and is characterized by contractions that are frequent, cramplike, but nonproductive.

Front 27

Decreased uterine muscle tone

Back 27

A woman who has contractions that are too weak to be effective during active labor. The woman will begin labor normally, but contractions diminish during the active phase of labor when the labor is supposed to accelerate.

Front 28

Ineffective maternal pushing

Back 28

During the second stage of labor, a woman may not push effectively because she does not understand which techniques to use or fears tearing.

Front 29

Macrosomia

Back 29

A large fetus, generally is considered to be one that weighs more than 4000g or 8.8lbs at birth.

Front 30

Shoulder dystocia

Back 30

When the fetal head is born but the shoulders become impacted above the mother’s symphysis pubis. This is an emergency because the fetus needs to breathe, the head may be out but the chest cannot expand.