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Reproduction and Sexuality > 3.2.3 Labor and Delivery > Flashcards

3.2.3 Labor and Delivery Flashcards

1
Q

What are some risk factors associated with shoulder dystocia?

A

Fetal macrosomia

Maternal diabetes

Maternal obesity

Post term gestation

Prior history of either macrosomia or should dystocia

Operative vaginal delivery

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2
Q

What are the principle movements of labor?

A

Engagement

Descent

Flexion at the neck

Internal rotation at the neck

Extension at the neck

External rotation at the neck

Expulsion

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3
Q

What are you cutting in a mediolateral episiotomy?

A

Mediolateral – cut bulbocavernosus muscle

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4
Q

What are the 3 Ps of dystocia?

A

Power

Passenger

Passage

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5
Q

What are the risk factors associated with a cord prolapse?

A

Low birth weight <2.5kg

Preterm birth

Breech presentation

Multiple gestation

Malpresentation (transverse lie)

Hydramnios

Obstetrical interventions

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6
Q

What is the management for cord prolapse?

A

Recognize

Call for help

Relieve

Remove

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7
Q

Describe the rate of cervical dilation during the different phases of the cervical phase

A
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8
Q

What are some clinical findings that suggest possible shoulder dystocia?

A
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9
Q

What is used to correct inadequate power in dystocia?

A

Inadequate uterine contraction activity can usually be corrected by infusion of oxytocin to both strengthen and increase the contraction frequency

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10
Q

Birth canal = ?

A

The True pelvis

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11
Q

What is shoulder dystocia?

A

When, after delivery of the fetal head further expulsion of the infant is prevented by impaction of the fetal shoulders within the maternal pelvis

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12
Q

What are the neonatal complication associated with shoulder dystocia?

A
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13
Q

What are the different types of Umbilical cord prolapse?

A
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14
Q

What are the characteristics of the placental stage?

A

Begins with the delivery of the baby

Ends with the delivery of the placenta

Relies on involution of the uterus through continued contractions to affect separation of the placenta

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15
Q

If there is a cord prolapse, why should the handling of the cord be reduced to a minimum?

A

Reduce the risk of vasospasm

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16
Q

What are the characteristics of should dystocia?

A
17
Q

What are some maneuvers to alleviate shoulder dystocia?

A
18
Q

What is the Term in Pregnancy?

A

38-42 Weeks of Pregnancy

Weeks of pregnancy are dated from the first day of the patients last menstrual period

Normal pregnancy is 40wks

Normal labor and delivery accounts for over two thirds of pregnancies.

19
Q

What is the prevalence of the different types of pelvis?

A
20
Q

What are the characteristics of the cervical stage?

A

Begins with the onset of labor

Ends when the cervix is fully dilated

Follow a characteristics course in a normal labor

Gets shorter with subsequent pregnancies

21
Q

What is an episiotomy?

A

Cut on the posterior side of the vagina - enlarges the vaginal outlet to facilitate delivery

22
Q

What are the problems associated with an android pelvis?

A

Appears to narrow inferiorly

Baby can get stuck

23
Q

What are the covered parts?

A
24
Q

What is an umbilical cord prolapse?

A

When the umbilical cord descends in advance of the presenting fetal part

25
Q

What are the advantages/disadvantages of midline episiotomy?

A

Midline – less pain, easy repair, could extend to anus

26
Q

What are the problems associated with an platypelloid (flat) pelvis?

A

Almost no room in pelvis for any internal rotation to occur - head stuck in transverse position

Transverse arrest of the fetal head

27
Q

Why can the passenger create problems in dystocia?

A

Estimated fetal weight (macrosomia) at the time of labor can provide clues to possible difficulties for the fetus making its way through the birth canal

Malpositioning can increase the diameter trying to negociate the pelvis

28
Q

What position will you move the mother to if there is a cord prolapse?

A

Trendelenburg position - raise the foot of the bed

or

Knee-Chest position

29
Q

What are the characteristics of the Expulson phase?

A

Begins at full cervical dilation

Ends with delivery of the baby

Aided by use of abdominal muscles in a valsalva-like maneuver to bring pressure to bear on the uterine fundus

Effective pushing can double the expulsive forve of the uterus

30
Q

What are the problems associated with an anthropoid pelvis?

A

Wider at the bottom

occiput remains posterior, can’t curve around pubic bone (no hyperflexion)

31
Q

What is dystocia?

A

Difficultly with delivery

32
Q

What is the physician measuring in this image?

A

Diagonal conjugate

Reproduction and Sexuality (58 decks)

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