Ch32 Labor/Birth Complications (Exam 2 study guide) Flashcards
regular uterine contractions along with cervical changes (dilation) occurring between 20 and 37 weeks of pregnancy
preterm labor
any birth that occurs between 20 and 37 weeks of gestation
preterm birth
birth that occurs between 34 and 36 weeks gestation
late preterm birth
birth that occurs before 32 weeks of gestation
the great majority of deaths and most serious morbidity occur to infants born at this time
very preterm birth
weight at the time of birth of 2500 g or less
low birth weight (LBW)
condition of inadequate fetal growth not necessarily correlated with initiation of labor
intrauterine growth restriction (IUGR)
glycoprotein found in plasma and produced during fetal life
(its reappearance in the cervical mucus during late second and early third trimesters of pregnancy may be related to placental inflammation, which is thought to be one possible cause of spontaneous preterm labor)
fetal fibronectins
spontaneous rupture of the amniotic sac and leakage of fluid before the completion of 37 weeks gestation most likely occurring as a result of pathogenic weakening of the amniotic membranes by inflammation, stress of uterine contractions, or other factors that cause increased intrauterine pressure
preterm premature rupture of membranes (PPROM)
spontaneous rupture of the amniotic sac and leakage of amniotic fluid before the onset of labor at any gestational age
prelabor rupture of membranes (PROM)
a bacterial infection of the amniotic cavity that is potentially life threatening for the fetus and the woman
(it is the most common maternal complication of PROM)
chorioamnionitis
long, difficult, or abnormal labor caused by various conditions associated with the five factors affecting labor
dysfunction labor (dystocia)
abnormal uterine activity often experienced by an anxious first-time mother who is having painful, uncoordinated, and frequent contractions that are ineffective in causing cervical dilation and effacement to progress
(they usually occur in the latent phase of the first stage of labor)
hypertonic uterine dysfunction
or
primary dysfunctional labor
abnormal uterine activity that usually occurs when a woman initially makes normal progress into the active phase of the first stage of labor but then uterine contractions become weak and inefficient or stop all together
hypotonic uterine dysfunction
or
secondary uterine inertia
abnormal labor caused by contractures of the pelvic diameters that reduce the capacity of the bony pelvis, including the inlet, midpelvis, outlet, or any combination of these planes
pelvic dystocia
abnormal labor caused by obstruction of the birth passage by an anatomic abnormality other than that involving the bony pelvis
(the obstruction may result from placenta previa, leiomyomas (uterine fibroid tumors), ovarian tumors, or a full bladder or rectum)
soft tissue dystocia
abnormal labor caused by fetal anomalies, excessive fetal size, malpresentation, malposition, or multifetal pregnancy
fetal dystocia
excessive fetal size
macrosomia
abnormal labor caused by excessive fetal size in relation to the size of the maternal pelvis
cephalopelvic disproportion (CPD) or fetopelvic disproportion (FPD)
the most common fetal malposition
occipitoposterior
the most common form of malpresentation
breech
gestation of twins, triplets, quadruplets, or more
multifetal pregnancy
labor pattern that lasts less than 3 hours from the onset of contractions to the time of birth, sometimes resulting from hypertonic uterine contractions that are tetanic (intermittent, irregular, spontaneous) in intensity
precipitous labor
attempt to turn the fetus from a breech or shoulder presentation to a vertex presentation for birth by exerting gentle, constant pressure on the abdomen
external cephalic version (ECV)
observance of a woman and her fetus for a reasonable period of spontaneous active labor (e.g., 4-6hrs) to assess the safety of a vaginal birth for both
trial of labor
chemical or mechanical initiation of uterine contractions before their spontaneous onset for the purpose of bringing about birth
induction of labor
rating system used to evaluate the inducibility of the cervix
Bishop score
the 5 characteristics of the Bishop score
dilation (cm) effacement (%) station (cm) cervical consistency cervical position
artificial ROM often used to induce labor when the cervix is ripe or to augment labor if progress begins to slow
amniotomy
stimulation of uterine contractions after labor has started spontaneously but unsatisfactory
augmentation
common methods of augmentation
oxytocin infusion
amniotomy
hypertonic uterine contractions that are tetanic in intensity
uterine tachysystole
birth method in which an instrument with two curved blades is used to assist the birth of the fetal head
forceps-assisted birth
birth method involving the attachment of a vacuum cup to the fetal head using negative pressure
vacuum-assisted birth
or
vacuum extraction
birth of the fetus through a trans abdominal incision of the uterus
cesarean section
pregnancy that extends beyond the end of 42 weeks gestation
post term, post date, or prolonged
uncommon obstetric emergency in which the head of the fetus is born but the anterior shoulder cannot pass under the pubic arch
shoulder dystocia
two major causes of shoulder dystocia
FPD
pelvic abnormalities
obstetric emergency in which the umbilical cord lies below the presenting part of the fetus
(it may be occult [hidden] or more commonly frank [visible])
umbilical cord prolapse
nonsurgical disruption of all the uterine layers
it is a rare but life-threatening obstetric injury occurring during labor and birth
rupture of the uterus
major risk factors for uterus rupture
scarred uterus
usually occurs during TOLBAC
obstetric emergency in which amniotic fluid enters the maternal circulation triggering a rapid, complex series of pathophysiologic events leading to disseminated intravascular coagulation (DIC), hypotension, and hypoxia
amniotic fluid embolism (AFE)
or
anaphylactoid syndrome
an antenatal glucocorticoid administered intramuscularly to accelerate fetal lung maturation when there is risk for preterm birth
(its use results in an increase in the production and release of surfactant)
betamethasone
b2-adrenergic agonist administered subcutaneously
- it relaxes uterine smooth muscles and is used to diagnose preterm labor, temporarily suppress preterm labor, or treat uterine tachysytole
terbutaline (Brethine)
a calcium channel blocker administered orally
- it relaxes smooth muscles, including those of the contracting uterus
- maternal hypotension is a concern
nifedipine (Procardia)
classification of medications given to arrest labor after uterine contractions and cervical change have occurred
tocolytic
a CNS depressant used during preterm labor for its ability to relax smooth muscles, including those of the uterus
- administered IV
magnesium sulfate
a prostaglandin synthesis inhibitor that relaxes uterine smooth muscles
- administered orally
indomethacin (Indocin)
tocolytic medication administered subq to suppress uterine tachysystole
terbutaline (Brethine)
classification of medications that can be used to ripen the cervix, stimulate uterine contractions, or both
prostaglandin
cervical ripening agent in the form of a vaginal insert that is placed in the posterior fornix of the vagina
dinoprostone (Cervidil)
cervical ripening agent in the form of a gel that is inserted in the cervical canal just below the internal os
dinoprostone (Prepidil)
pituitary hormone used to stimulate uterine contractions in the augmentation or induction of labor
oxytocin (Pitocin)
natural cervical dilator made from desiccated seaweed
laminaria tent
synthetic cervical dilator containing magnesium sulfate
Lamicel
cervical ripening agent, used in the form of a tablet that is most commonly inserted intravaginally in the posterior fornix
misoprostol (Cytotec)
