B8-017 Labor and Delivery Flashcards
[what stage of labor]
begins with the onset of labor
ends when cervix is fully dilated
1st- cervical stage
which stage of labor gets shorter with each subsequent pregnancy?
1st (cervical stage)
[…] phase of labor is slow dilation over a longer period of time
latent
[…] phase of labor is rapid dilation over a short period of time
active
[what stage of labor]
begins at cervical dilation
ends with delivery of baby
2nd-expulsion stage
[what stage of labor]
begins with delivery of the baby
ends with delivery of the placenta
3rd- placental stage
signs of placental separation [3]
(indicates it is safe to apply traction to cord)
increase in vaginal bleeding
lengthening of umbilical cord
uterus changes shape
risks of attempting to deliver the placenta too early, before separation [2]
avulsion of cord
inversion of uterus
the fetus is considered engaged in the pelvis when the head reaches the […] on vaginal exam
ischial spines
no cervical dilation for more than two hours may indicate
arrest of labor
cervical dilation rate less than 1 cm/hour may indicate […] of labor
protraction
no descent after one hour of pushing is […] of labor
arrest
3 Ps for dystocia
passage
passenger
power (increased with oxytocin)
persistent occiput posterior is associated with […] pelvis
anthropoid
deep transverse arrest of fetal head is associated with […] pelvis
platypelloid
arrest of descent is associated with […] pelvis
android
membranes are intact and the cord is felt in the bag of membrane at the internal cervical os
funic presentation of cord prolapse
umbilical cord is lying beside the presenting fetal part
occult presentation of cord prolapse
cord is protruding through the cervix into and sometimes from the vagina
overt prolapse
management manuevers for shoulder dystocia
McRoberts
suprapubic pressure
deliver fetal posterior arm
corkscrew
fracture fetal clavicle
waiter’s tip hand
Erb’s palsy
claw hand
klumpke’s palsy
if there has been a decrease in uterine contractions, is it safe to apply traction to the umbilical cord?
no
engagement means the presenting part of the fetus has reached the […] on vaginal exam
ischial spines
no change in dilation for over two hours indicates
arrest of labor
arrest of descent occurs in the second stage of labor, after
full dilation
cervical change at a slower than predicted rate
protraction of labor
pelvis shape least likely to obstruct labor
gynecoid
pelvic shape associated with persistent occiput posterior position
anthropoid
persistent transverse arrest is seen in patients with a […] pelvis
platypelloid
arrest of descent with occiput anterior is more likely to occur in patients with […] pelvis
android
occurs in situations where the fetal presenting part does a poor job sealing the cervix
cord prolapse
initial steps to managing a shoulder dystocia
mcroberts maneuver and suprapubic pressure
