Chapter 13 Flashcards
Relaxin
tissues relax causing the pelvis to relax
Contractions have two functions
dilate the cervix and push the baby out
At the end of pregnancy, what hormone is an increase
oxytocin receptors
what do prostaglandins lead to
additional contractions
Dilation
opening or enlargement of the external cervical os
Lightening
the fetal presenting part begins to descend into the true pelvis; the uterus lowers and moves into a more anterior position
Lightening decreases what symptoms? and increases what
decreases breathing difficulty, gastric reflux
increase in urination and vaginal discharge
Bloody show
mucous plug that fills the cervical canal is expelled
what is 34 0/7- 36 6/7
late preterm
Nesting
energy level increases usually occur 24-48 hours before labor begins
Braxton hicks contractions
Decreased by activity, voiding, eating, changing position, and increasing fluid intake.
if contractions last longer than 30sec and more then 4-6 times an hour call MD
PROM
prelabor rupture of membranes; labor usually begins within 24 hrs, the barrier to infection is gone, the danger of cord prolapse if engagement has not occurred
True labor
in the back, a regular contraction that doesn’t change with activity, become stronger, makes cervical changes
5 p’s are
passageway, passenger, powers, position, and psychological
Three names of true pelvis passageway
pelvic inlet, mid-pelvis, and pelvic outlet
Mid-pelvis does what
compresses chest causing lung fluid and mucus to be expelled
True pelvis lies
below linea terminals
Pelvic shape; Gynecoid
true female pelvis, vaginal birth most favorable, inlet round & outlet roomy, O
Anthropoid
common in men & nonwhite women 0
Android
male shaped pelvis, labor is poor, leads to c section, heart shaped
platypelloid
less common, c section required flat,
effacement
the cervix thins to allow presenting part to descend
Passenger: fetal head
largest fetal structure
Molding
overlapping of cranial bones
Caput succedaneum
fluid collects over scalp crosses suture lines
cephalohematoma
blood collected beneath the scalp doesn’t cross suture lines
Anterior fontanelle
“soft spot” diamond-shaped 1- 4cm, closes between 12- 18 months
Posterior fontanelle
back of the head, triangular, 1-2cm and closes at 8-12 weeks
Fetal attitude
posturing flexion or extension
fetal lie
relationship of a fetal spine to the maternal spine, longitudinal 11 and parallel +
Fetal presentation
the body part that enters the pelvic inlet first, cephalic, breech, and shoulder
explain vertex, brow, face and military
vertex is back of the head, brow eyebrow coming first, face coming first and the military is straight
sign for shoulder dystocia
turtle sign
Fetal position
right or left, presenting part and presenting part in relate to the anterior position of mother, LOA and ROA most favorable
Fetal station
0= ischial spine
- is above spine
+ below
Engagement
head through inlet or 0 station
floating
when engagement has not occurred
cardinal movements of labor
Every, Darn, Fool, In, Egypt, Eats Raw, Eggs
engagement, descent, flexion, internal rotation, extension, external rotation, expulsion
Powers: cervical canal 2cm, 1cm and 0cm
0% effaced, 50%, 100%
Contractions have three phases
increment, acme Peak, decrement
Frequency
How often, measured from the start of one contraction to the next.
Duration
how long contraction lasts, measured from the start of one to end of the contraction
intensity
Strength measured internal uterine cath.mild= nose, moderate= chin, sever= head
requirements for induction
-2 station, 3 cm, high risk for c section
what intensity causes cervical changes
30 promote but high will do real work
stages of labor
first, second, third, fourth
the first stage has three phases
latent = 0-3, 0%-40%, 5-10mins, 30-45 sec, mild(longest) Active= 4-7, 40%-80%, 2-5min, 45-60sec, moderate transition= 8-10, 80%-100%, 1-2min, 60-90sec, strong(shortest)
first stage
starts with first true contraction and ends with full dilation
second stage
starts with full dilation and ends with the birth of
newborn; pelvic phase head of the fetus is rotating and descending
Perineal phase strong urge to push
third stage
birth of a newborn to the birth of the placenta
Blood loss
500 for vaginal and 1000mL for c section
fourth stage
expulsion of placenta adjustment of mother
shiny Schultz
the shiny grey side of the placenta
dirty Duncan
the red- raw side
crowning
fetal head no longer regresses with contractions
