Chapter 16 Flashcards
Factors Affecting Labor
Passenger Passageway Powers Position Psychologic
Passenger
Fetus
Important details include size of fetal skull, fontanels, and molding
Presentation is usually vertex/cephalic
Want baby to come out face down
Fetal Lie
Most common is longitudinal (head down)
Fetal Attitude
Relation of fetal body parts to one another
We want GENERAL FLEXION
Fetal Position
Relationship of a reference point on the presenting part to the four quadrants of the mother’s pelvis
Denoted by a three part letter abbreviation
Fetal Station
A measure of the degree of descent of the presenting part of the fetus through the birth canal
Zero station at ischial spines
Zero station also known as fetal engagement
Primary Powers
Contractions
Measured in frequency, duration, and intensity (signs of true labor)
Effacement and dilation are necessary
Ferguson reflex is the need to push
Secondary Powers
Bearing-down efforts, Valsalva maneuver
Vaginal Exams
Sterile procedure
Performed before analgesia and anesthesia, to determine progress of labor, and to determine if second stage pushing can begin (full dilation and 100% effacement achieved)
Signs Preceding Labor
Lightening, bloody show, “nesting”
First Stage of Labor
Onset of regular contractions leads to full dilation and effacement
Latent phase (cervix effacing)
Active phase (increased dilation, more of engaged part coming down)
Transition phase
Second Stage of Labor
Cervix is dilated and leads to birth of the baby
Third Stage of Labor
Whole body and placenta are delivered
Fourth Stage of Labor
Mother most vulnerable to hemorrhage (minimum of 2 hours postpartum)
Seven Cardinal Movements of Mechanism of Labor
Engagement
Descent
Flexion
Internal rotation
Extension
Restitution and external rotation
Expulsion
