Conduct Of Normal Labor And Delivery Flashcards
This fetal lie presents in over 99% of labors at term
Longitudinal
It is the relation of the long axis of the fetus to the mother
Fetal Lie
Predisposing factors in a transverse lie includes (4)
Multiparity
Placenta previa
Hydramnios
Uterine anomalies
This fetal lie fetal and maternal axes may cross at a 45 degree angle
Oblique lie
This lie is usually unstable and always becomes longitudinal or transverse during the course of labor
Oblique lie
Characteristic posture of the fetus in the later months of pregnancy
Fetal Attitude
Also known as Fetal Habitus or Posture
Fetal Attitude
Fetus forms an ovoid mass that correspond roughly to the shape of the uterine cavity
Fetal Attitude
Portion of the fetal body that is either foremost within the birth canal or in closest proximity to it
Fetal presentation
When thighs are flexed and the legs are extended over the anterior surface of the body
Frank breech
If the thighs are flexed on the abdomen and the legs upon the thighs
Complete breech
One or both feet or one or both knees are the lowermost
Incomplete breech or Footling breech
Refers to the relationship of an arbitrarily chosen portion of the fetal presenting part to the left or right side of the birth canal
Fetal Position
The shoulder presentation, the ____ is the portion of the fetus arbitrarily chosen for the orientation in the maternal pelvis
Acromion
Its is customary to refer all transverse lies simply as ___
Shoulder presentation
Another term used is transverse lie with ____
Back up or Back down
This Leopolds manuever is done when the examiner stands on the side of the bed and faces the patient
L1-2-3
This Leopolds maneuver is done when the examiner reverses this position and faces her feet for the last maneuver
L4
Leopolds maneuver is difficult if not impossible to perform and interpret if the patient ___ or ____
Obese
Placenta is anteriorly implanted
First maneuver is also know as ___
Fundal grip
Examiner gently palpates the fundus with the tips of the fingers of both hands to define which fetal pole is present in the FUNDUS
First maneuver
What can be interpreted in the first maneuver
Breech or Cephalic
When sensation of a large, nodular body
Breech
Hard and round which is more freely movable and balottable
Cephalic
Second maneuver is also known as ___
Lumbar grip
The palms are placed on either side of the abdomen and gentle but deep pressure is exerted
Second maneuver
What can be determined in the second maneuver
Back or Extremities
This renders a hard and resistant
Back
This renders numerous small, irregular and mobile parts
Extermities
Other name for the third maneuver
Pawlik’s grip
Using the thumb and fingers on one hand, the lower portion of the abdomen is grasped just above the symphysis pubis
Third maneuver
The other name of the fourth maneuver
Pelvic grip
The tips of the three fingers of each hands exert deep pressure in the direction of the axis of the pelvic inlet
Fourth maneuver
What can be detected in the fourth maneuver
Vertex presentation or Face presentation
The prominence is on the same side as the small parts
Vertex presentation
The prominence is on the same side as the back
Face presentation
What are the cardinal movement of labor
Engagement Descent Flexion Internal rotation Extension External rotation Expulsion
Mechanism by which the biparietal diameter, the greatest transverse diameter of the fetal head passes through the pelvic inlet
Engagment
Fetal head may engage during the ____ or ______
Last few weeks of pregnancy
Not until after the commencement of labor
Fetal head is freely movable above the pelvic inlet at the onset of labor
Floating head
The fetal head usually enters the pelvic inlet either ___ or ___
Transversely or obliquely
First requisite of birth of the newborn
Descent
In nulliparas, the engagement may take place ____ and further descent may not follow until ____
Onset of labor
Not follow until the onset of the second stage
In multiparous women, descent usually begins ___
With engagement
Descent is brought to you by one or more 4 forces:
- Pressure of the amniotic fluid
- Direct pressure on the fundus upon breech with contraction
- Bearing down efforts of the maternal abdominal muscle
- Extension and straightening of the fetal body
The chin is brought into more intimate contact with fetal thorax
Flexion
Suboccipitobregmatic diameter in flexion is substituted with ____
Occipitofrontal diameter
Consists of turning of head in such a manner that the occiput gradually moves toward the symphysis pubis anteriorly from its original position
Internal rotation
This is essential for the completion of labor, except when the fetus is ___
Internal rotation
Unusually small
This happens when the head presses upon the pelvic floor
Extension
2 forces involves in during extension:
- Exerted by the uterus (acts more posteriorly)
2. Resistant of the pelvic floor and the symphysis pubis (acts more anteriorly)
Delivered head undergoes reinstitution
External rotation
Brings its bisacromial diameter in the relation with the AP diameter of the pelvic outlet
External Rotation
Almost immediately after external rotation
Expulsiom
The anterior shoulder appear under the symphysis pubis
Expulsion
Perineum soon becomes distended by the posterior shoulder
Expulsion
After delivery of the shoulders, the rest of the body quickly passes
Expulsion
Its is the lateral deflection of the head to a more anterior or posterior position in the pelvis
Asynclitism
Two types of asynclitism
Anterior
Posterior
If the sagittal suture approaches the sacral promontory
Anterior asynctilism
More of the anterior parietal bone presents itself to the examining fingers
Anterior synctilism
The sagittal suture lies closes to the symphysis
Posterior asynctilism
More of the posterior parietal bone will present
Posterior asynctilism