Exam 2 part 4 Flashcards
used to relax uterus during external version
terbutaline
the relationship of the presenting part to the specific area of the womans pelvis
fetal position
Sunny side up
Longer labors
Spontaneous or assisted rotation to OA
Some feel that sedentary behavior in mom increases
occiput posterior
more than just a head
Associated with umbilical cord prolapse
Ex. arm up by head
compound presentation
are the meetings of the bones of the fetal skull
Covered by a membrane
sutures
are the space where two sutures meet
Covered by membrane
fontanelles
posturing of the joints and the relationship of the fetal body parts (chest, chin, arms) to each other
fetal attitude
normal fetal attitude when labor begins
flexion
is the process in which the fetus, placenta, and membranes are expelled sponstaneously
labor
begins with onset of labor and ends with complete cervical dilation
stage 1
makes up stage 1
Latent phase
Active phase
Transition phase
begins with complete cervical dilation and ends with delivery of baby
stage 2
begins after delivery of baby and ends with delivery of placenta
stage 3
begins after delivery of placenta and is completed 4 hours later
stage 4
cervix 0-3 cm dilation 0-40% effacement
Contraction every 5-10 min, mild intensity
Discomfort described as feelings of strong menstrual cramps
latent phase
Average dilation 1.2 cm/hr depending on gravida 4-7 cm dilation 40-80% effacement Fetal descent Intense contractions q 2-5 min Increase in pain
active phase
Dilation from 8-10cm 100% effacement Contractions intense q 1-2 min Exhaustion, difficulty concentrating Bloody show Strong urge to bear down
transition phase
physician-attended births
lithotomy
difficult labor or childbirth
dystocia
disparity between the size of the maternal pelvis and the fetal head
cephalopelvic disproportion CPD
malpostion of the fetal head
asynclitism
slower than normal UC
protraction disorder
complete cessation of UC
arrest disorder
frequent contractions that cannot perform effectively
hypertonic
weak, ineffective contraction
hypotonic
artificial rupture of membranes
amniotomy
labor lasting more than 18-24 hours
prolonged labor
develops after excessive retraction of the upper segment
Hallmark of neglected labor
Above the ring is thick =, lower segments below os paper thin and can rupture
As the lower segment thins ring rises
Occurs late in the second stage
bandls retraction ring
labor that lasts less than 3 hours
enexpected fast delivery
used when fetal skull has reached the perineum
Scalp is visible between contraction
outlet forceps
used when fetal skull is at +2 station or more
low forceps
is the process of deliberate starting labor artificially
induction of labor
is artificial stimulation of labor that began spontaneously but has progressed abnormally
augmentation of labor
stimulation of ineffective UCs after the onset of spontaneous labor to manage labor dystocia
labor augmentation
is the process of physical softenting and opening of the cervix in preparation for labor and birth
ripening
inserted into the cervix
Made from seaweed, it expands and cause pressure
laminaria
Defined as five or more UCs in 10 min over 30 min window
Series of single UCs lasting 2 min or longer
UCs occurring within 1 min or each other
tachysystole
fetal vessels running through the membranes, over the cervix, and under the fetal presenting part unprotected by the placenta or umbilical cord
ruptured vasa previa
embolism forms when the amniotic fluid that contains fetal cells, lanugo, and vernix enters the maternal vascular system and results in cardiorespiratory collapse
anaphylactic syndrome (amniotic fluid embolism)
do not give this drug to drug dependent women
stadol (butorphanol)
position for epidural
position patient in side-lying position
drug into the subarachnoid cerebrospinal fluid space
The injection is usually made in the lumbar region at the L2/3 or L3/4 space punctures dura
spinal anesthesia
which occurs when the injection has been given unintentionally at the wrong site, is a rare but serious complication.
Is characterised by sudden hypotension, rapidly increasing motor block, temporarily loss of breathing, loss of consciousness, dilated pupils, and is preceded by respiratory distress due to the blockade of some nerve cells
Total spinal
Treatment for total spinal
maintain airway
place patient on side
ALAMER
Ask for help Leg hyperflexion (McRoberts maneuver) Anterior shoulder disimpaction Rubin maneuver Manual delivery of posterior arm Episiotomy Roll over on all fours
hyperflexing the mothers leg tightly to her abdomen
It is effective due to the increased mobility at the sacroilic joint during pregnancy, allowing rotation of the pelvis and facilitating the release of the fetal shoulder
McRoberts maneuver
posterior pressure on the anterior shoulder, which would bring the fetus in an oblique position with head somewhat towards the vagina
Rubins
leads to turning the anterior shoulder to the posterior and vise versa
Opposite of the rubins maneuver
Woods screw maneuver
delivery of the posterior shoulder first in which the forearm and hand are identified in the birth canal and gently pulled
Jacquemiers maneuver (barnums maneuver)
involves moving the mother to an all fours position with the back arched, widening the pelvic intentional fetal clavicular fracture, which reduces the diameter of the shoulder girdle that requires to pass through the birth canal
Gaskin maneuver
which makes the opening of the birth canal laxer by breaking the connective tissue between the two pubes bones facilitating the passage of the shoulder
maternal symphysiotomy
where a hysterotomy facilitates vaginal delivery of the impact shoulder outlet
abdominal rescue
is a form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth cervical (C8) and first thoracic (T1) nerves are injured either before or after they have joined to form the lower trunk. The subsequent paralysis affects, principally, the intrinsic muscles of the hand (notably the interossei, thenar and hypothenar muscles)[10] and the flexors of the wrist and fingers (notably flexor carpi ulnaris and ulnar half of the flexor digitorum profundus).[he classic presentation of Klumpke’s palsy is the “claw hand” where the forearm is supinated and the wrist and fingers are flexed. If Horner syndrome is present, there is miosis (constriction of the pupils) in the affected eye.
Klumpkes paralysis
