1st Lecture Flashcards
Gravida
of pregnancies
EDC or EDD
Nageles Rule
Estimated date of confinement or delivery
Calculates a 40 week pregnancy
LMP -3 mo and + 7 days
Para
of Births after twenty weeks live or dead
Abortion
Induced or spontaneous # of births prior to 20 weeks
Preterm
Less than 37 weeks
Term
of births after 37 weeks
Post term
After 40 weeks
Chadwick sign
Increased vascularity causes cervix to appear violet- bluish
Hegar sign
Softening of lower uterine segment
Goodell sign
Softening of cervical tip
Braxton hicks sign
Painless uterine contractions
Quickening
Perception of fetal movement (flutter)
Lightening
Fetus drops in pelvis (decreased fundal height)
Ballottement
Passive movement of fetus
Flexed fetal attitude
Best for labor
Suboccipitobregmatic diameter
Complete flexion of head on chest = smallest diameter
Fetal lie
Longitudinal or vertical
The best position for birth
Best way to determine a breech
Ultrasound
Breech
Head not down
Frank breech
The only breech that may be vaginally birthed
Types of pelvis shapes
- Gynecoid
- Android
- Anthropoid
- Platypelloid
Gynecoid
50% round pelvis- conducive to vaginal birth
Android
23% heart shaped- uncommon vaginal birth C- section likely
Anthropoid
24% vertical oval- vaginal birth possible but not likely
Platypelloid
3% horizontal oval- vaginal birth not ideal but possible
Primary forces of labor
Dilatation
Effacement
Descent
Contractions
Dilatation
Cervix opens to 10 cm
Effacement
Cervix thins to piece of paper- 0% is fully effaced
Descent
Station of fetus
Contractions
Frequency- beginning to beginning
Intensity- palpate fundus or measure w/ IUPC
Nose- mild chin- moderate forehead- strong to very strong
Duration- length of contraction
Maternal position
Do not lay flat on back- baby can suppress vena cava
Side- lying is usually moms favorite
Upright squatting with squat bar can be good for “op”
Secondary forces of labor
Bearing down urge
Possible causes of labor onset
Progesterone Estrogen Fetal Cortisol Prostaglandin Oxytocin Uterine Distention
Signs of labor onset
Lightening Cervical changes- best objective measure Bloody show Rupture of membranes Sudden burst of energy
True labor
~Contractions are regular intervals; become more frequent; more intense; and last longer over time
~intensity usually increases with walking
~progressive cervical dilatation and Effacement
~loss of mucous plug = water break
False labor
~Irregular contractions and no change in frequency intensity or length
~walking has no effect or lessens contractions
~no cervical change
~May lose mucous plug
Stages of labor
1st- beginning of true labor until complete cervical dilatation
2nd- complete dilatation to birth of baby
-baby is born
3rd- delivery of baby to delivery of placenta
-placenta delivered
4th- first four hours postpartum
Stage 1 of labor
Three phases:
- Latent phase- 0-3cm
- Active phase- 4-7cm
- Transition phase- 8-10cm
Cardinal movements (must be in order)
- Engagement
- Descent
- Flexion
- Internal rotation
- Extension
- External rotation (restition)
- Expulsion