2P - Dysfunctional Labor Flashcards
A primi patient with a dilatation rate of 1cm/hr is experiencing what event?
Protracted labor
What mechanism of dystocia is affected by mechanical relationship between fetal head size and position and pelvic cavity?
fetoplevic proportion
What is a possible sign of fetopelvic disproportion?
Ineffective labor
A patient under labor experiences inadequate contractions, what is the primary traetment?
Oxytocin
What is the normal pressure for spontaneous contractions?
60 mmHg
*Montevideo units for normal contractions is 200 mmHg
What is the lower limit of contraction required to dilate the cervix?
15 mmHg
What type of uterine dysfunction is present if there is normal gradient pattern but the force is insufficient?
Hypotonic uterine dysfunction
What part of the uterus does the strongest force of contractions occur?
Fundus
What part if the pregnant uterus does the weakest force of contraction occur?
LUS
What type of uterine dysfunction is present if there is distortion in the contraction gradient and basal tone is eleveted?
Hypertonic uterine dysfunction or incoordinate uterine dysfunction
In incoordinate uterine dysfunction, where does the contraction start sometimes (not in the fundus)?
Midsegment
What is a common cause of incoordinate uterine dysfunction in primi patients?
cephalopelvic disproportion
If the parietal bone of the fetus is deflected laterally and you can feel the ears upon inspection, what is the asynclitism present?
Posterior asynclitism
What is the presentation of the fetus if the head is well flexed?
Suboccipitobregmatic
*shortest diameter - ideal for labor
What is the presentation of the fetus if the fetal head is is mento occipital position?
Face presentation
*longest diameter - not ideal
When is the best time to assess the fetal head?
When cardinal movements happen
*at deceleration phase of labor
What pelvic conjugate will the fetal head pass through?
Obstetric conjugate
most obstetrically important
Greatest diameter of the inlet
Transverse diameter
The adequate measure for the interspinous diameter?
10 cm
median duration for primi patients on second stage of labor?
50 mins
2-3 hours depending on epidural use
median duration for multigtravid patients on second stage of labor?
30 mins
1-2 hours depending on epidural use
If the patient presents with slow yet progressive 1st stage of labor, what will be the management?
Oxytocin drip or amniotomy
How many hours after entering station 0 will failure of descent happen?
more than 1 hour in deceleration phase or 2nd stage of labor
Arrest of descent if below station 0
Time criteria for prolonged deceleration phase (8-9cm)?
Nulli - 3 hours
Multi - 1 hour
Prolonged second stage time criteria?
nulli - 2 hours w/o 3 hrs w/ epidural
multi - 1 hr w/o 2 hours w/ epidural
the phase of predictive outcome of the labor?
Early active phase or acceleration phase
4-5 cm
active phase predictive of fetopelvic relationship?
Deceleration phase
Phase which shows the the overall efficiency of the machine?
Phase of maximum slope
Division of labor with very little changes?
Preparatory division
How many cm does deceleration phase start?
8cm
What is the purpose of Zhang’s curve?
Decrease unnecessary CS
Primi patient cervically dilated, approximately how many hours before fully dialted?
4 hours
