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COM Endo Repro Exam 2 > 15: Normal Labor and Delivery > Flashcards

15: Normal Labor and Delivery Flashcards

1
Q

Definition of Labor

A

Progressive cervical dilation resulting from regular uterine contractions occurring at least every 5 minutes lasting 30-60 sec

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2
Q

False Labor/Braxton-Hicks contractions

A

Irregular contractions without cervical change

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3
Q

Most optimal pelvic shapes for vaginal delivery

A

Gynecoid and Anthropoid

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4
Q

Fetal Lie

A

Maternal spine to fetus spine; infant can be longitudinal, transverse, oblique

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5
Q

Fetal presentation

A

Presenting part to pelvis: vertex, breech, transverse, compound

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6
Q

Leopold maneuver

A

Determines station and lie; 1. Palpate fundus, 2. Palpate spine and fetal parts, 3. Palpate presenting pelvis with suprapubic palpation, 4. palpate for cephalic prominence

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7
Q

Dilation of cervix

A

Check at level of internal os; complete dilation at 10 cm

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8
Q

Effacement of cervix

A

Thinning of cervix reported as % change

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9
Q

Station of cervix

A

Degree of descent of presenting part of the fetus; range -5 to +5; 0 when bony portion of head reaches level of ischial spines

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10
Q

First stage of labor

A

Onset of true labor to complete cervical dilation (with latent and active phase)

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11
Q

Second stage of labor

A

Complete cervical dilation to delivery of infant

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12
Q

Third stage of labor

A

Delivery of infant to delivery of placenta

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13
Q

Fourth stage of labor

A

Delivery of placenta to stabilization of patient

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14
Q

During first stage of labor, how often do you perform cervical checks?

A

Q2hr

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15
Q

What is meant by 4/50/-2?

A

Dilation/Effacement/Station; 4 cm dilated/50% effaced/-2 cm station

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16
Q

Amniotomy (AROM) - benefits and risks

A

Artificial rupture of membranes
Benefits: augment labor, allow assessment of meconium status
Risks: cord prolapse, prolonged leads to chorioamnionitis

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17
Q

Cardinal movements of labor

A
  1. Engagement, 2. Descent, 3. Flexion, 4. Internal rotation, 5. Extension, 6. External rotation, 7. Expulsion
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18
Q

Engagement (cardinal movements)

A

Presenting part at zero station

19
Q

Descent (cardinal movements)

A

D/t force of uterine contractions and maternal valsalva

20
Q

Flexion (cardinal movements)

A

OA-baby’s chin to chest; suboccipitobregmatic

21
Q

Internal rotation (cardinal movements)

A

Fetal head enters pelvis in transverse diameter, rotates so occiput is anterior or posterior toward pubic symphisis (usually occurs at ischial spines)

22
Q

Extension (cardinal movements)

A

Crowning occurs when largest diameter of fetal head encircled by introitus; station is +5, head born by rapid extension

23
Q

External rotation (cardinal movements)

A

Delivered head returns to original position to align with fetal back and shoulders

24
Q

Expulsion (cardinal movements)

A

Anterior shoulder then delivers under pubic symphysis; followed by posterior shoulder and rest of body

25
Q

Most common maternal position for spontaneous and operative delivery

A

Dorsal lithotomy

26
Q

Modified Ritgen maneuver

A

Stabilize perineum with towel to facilitate delivery, extend head and apply counter-pressure

27
Q

First degree perineal laceration

A

Superficial laceration involving vaginal mucosa/perineal skin

28
Q

Second degree perineal laceration

A

Laceration extending into muscles of perineal body

29
Q

Third degree perineal laceration

A

Laceration extends into or completely through anal sphincter

30
Q

Fourth degree perineal laceration

A

Involves rectal mucosa

31
Q

Retained placenta

A

Diagnosed if placenta has not delivered within 30 minutes; usually occurs within 2-10 minutes

32
Q

Most common cause of postpartum hemorrhage

A

Uterine atony

33
Q

Induction of labor

A

Process by which labor is induced by artificial means

34
Q

Augmentation of labor

A

Artificial stimulation of labor which has ALREADY BEGUN

35
Q

Bishop Score

A

Probability of labor by characteristics of cervix; measures likeihood of need for C-section

36
Q

Unfavorable Bishop score

A

Less than 6; increased likelihood of C-section

37
Q

Cervidil (dinoprostone)

A

Cervical ripening agent (PGE2); vaginal insert; Contraindicated in pt with previous C-sections

38
Q

Cytotec (misoprostol)

A

Cervical ripening agent (PGE1); oral or vaginal; Contraindicated in patients with previous C-sections

39
Q

Mechanical dilators of the cervix

A

Foley bulb, laminara japonicum

40
Q

Pitocin

A

Synthetic oxytocin, IV administration; only FDA approved drug for induction and augmentation

41
Q

Complications of pitocin

A

Uterine tachysystole (most common), antidiuretic effect (water reabsorption), uterine muscle fatigue

42
Q

Epidural

A

Most effective form of anesthesia/pain relief; large bore needle between L2-3/3-4/4-5

43
Q

When is an inhaled anesthetic indicated in delivery?

A

Emergent cases with need for rapid delivery; ALL cross placenta and associated with neonatal respiratory depression

COM Endo Repro Exam 2 (15 decks)

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