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OB > 4.2a Factors affecting labor, passenger, pathway, power, position, psychology > Flashcards

4.2a Factors affecting labor, passenger, pathway, power, position, psychology Flashcards

1
Q

FACTORS AFFECTING LABOR

A
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2
Q

Passengers of Labor

A
  • These include the fetus and placenta
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3
Q

Passageway of Labor

A
  • Mothers birth canal
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4
Q

Powers of Labor

A
  • Contractions
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5
Q

Position of Labor

A
  • Mothers position
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6
Q

Psychology of Labor

A
  • Psychologic Response
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7
Q

Passenger of Labor Factors

A
  • How the baby moves through the birth canal determined by
  • Size of fetal head
  • Fetal presentation
  • Fetal lie
  • Fetal attitude
  • Fetal position
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8
Q

Fetal Bones

A
  • 2 Parietal
  • 2 Temporal
  • 1 Frontal
  • 1 Occipital
    These bones are connected by sutures
    Fontanels are where more than 2 bones meet
  • Anterior fontanel is larger and diamond shaped (closes by 18 months)
  • Posterior fontanel is smaller and closes within 6-8 weeks
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9
Q

Fetal Head

A
  • After rupture of membranes palpation of these fontanels and sutures tells the fetal presentation, position and attitude.
  • Sutures and fontanels make the skull flexible to accommodate the growing brain
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10
Q

MOLDING

A
  • Slight overlapping of skull bones
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11
Q

Fetal Presentation

A
  • The part of the fetus that leads through the birth canal
    Cephalic Presentation - Head first (Occipital)
    Breech Presentation - Butt/Feet first (Sacrum)
    Shoulder presentation - Shoulder first (Scapula)
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12
Q

Fetal Lie

A
  • How the babies spine lines up with the mothers spine
    Longitudinal - Parallel
    Transverse - At a right angle with mothers spine (cannot be birthed this way)
    Oblique lie - Lying at an angle but usually converts to longitudinal during labor
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13
Q

Fetal Attitude

A
  • Relation of fetal body parts to one another
    Complications
  • Fetal head may be extended where it is too big to fit through maternal pelvis
    (Prolonged labor, forceps, vacuum assisted birth, c-section)
  • Diameter of fetal head is measured by ultrasound
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14
Q

Biparietal Diameter

A
  • Largest transverse diameter (widest part of head entering pelvic inlet)
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15
Q

Suboccipitobregmatic Diameter

A
  • Smallest part of head entering pelvic pelvic inlet

- When head is in complete flexion it allows to pass through pelvis easily

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16
Q

Fetal Position

A

L - Left
R - Right

O - Occiput
S - Sacrum
M - Mentum (chin)
Sc - Scapula (shoulder

A - Anterior
P - Posterior
T - Transverse

17
Q

Station

A
  • Measures degree of descent of presenting part of baby through birth canal
  • Measured above or below ischial spines
  • Goes from -5 cm to +5 cm
  • Leveled with the spine is = 0
  • Birth imminent at +4 to +5
18
Q

Engagement

A
  • This is when the largest transverse diameter of presenting part has passed the maternal pelvic brim or inlet into the true pelvis (station 0)
  • Determined by abdominal or vaginal examination
19
Q

Passageway

A
  • Composed of bones of pelvis, tissues of cervix, pelvic floor, vagina, introitus (opening of vagina)
  • Muscle layers of pelvic floor play a large role in birth of fetus
  • Pelvis plays large role in labor process
20
Q

Pelvis

A
  • Fusion of ileum, ischium, pubis, sacral bones
  • False pelvis plays no role in birth
  • True pelvis plays a role in birth
21
Q

TYPES OF PELVIS

A

Gynecoid - Classic Female Pelvis
Android - Resembles Male Pelvis
Anthropoid - Oval shaped with larger Anteroposterior diameter
Platypelloid - Flat pelvis

22
Q

Soft Tissue of Passageway

A
  • Lower uterine segment
  • Cervix
  • Pelvic Floor Muscle
  • Vagina
  • Introitus
23
Q

Powers of Delivery

A
24
Q

Primary Powers

A
  • Involuntary uterine contractions
  • Signals the beginning of labor
  • Responsible for effacement and dilation of cervix

FREQUENCY - Time from 1 contraction to the next
DURATION - Length of contraction
INTENSITY - Strength of contraction at its peak

25
Q

Effacement

A
  • Shortening and thinning of the cervix during 1st stage of labor
  • Expressed as 0-100%
26
Q

Dilation

A
  • Widening of the cervical opening

- Increases from 1cm to 10cm

27
Q

Ferguson Reflex

A
  • Stretch receptors in vagina release oxytocin which triggers mother urge to bear down
28
Q

Secondary Forces

A
  • Voluntary (bearing down) efforts by mother
  • Aids in expulsion of fetus
  • Begins once fetus reaches pelvic floor
    EXPULSIVE - involuntary urge to push
29
Q

Position of Laboring Woman

A
  • Frequent changes in position reduce fatigue, increase comfort, improve circulation
30
Q

Psychology of Labor and Birth

A
  • Enhanced through physical, emotional, social support

- Better social support has shown to reduce labor times, control pain better, less need for medication

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