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Obstetrics > Factors Affecting L&D > Flashcards

Factors Affecting L&D Flashcards

1
Q

Passageway

A

Ability of pelvis & cervix to accommodate passage of fetus

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2
Q

Four pelvis types and most ideal

A
  1. Gynecoid
  2. Anthropoid
  3. Android
  4. Platypelloid
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3
Q

Passenger refers to

A

Ability of fetus to complete birth process

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4
Q

Define molding

A

cranial bones overlap under pressure of the powers of labor and demands of unyielding pelvis

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5
Q

What is the largest transverse diameter of the fetal skull?

A

Biparietal

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6
Q

What is the smallest transverse diameter of the fetal skull?

A

Suboccipitobregmatic

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7
Q

Fetal attitude

A

Relationship of fetal parts to one another, particularly to head

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8
Q

Optimal fetal attitude

A

Flexed

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9
Q

Fetal lie

A

refers to relationship fetal spine (cephalocaudal axis) to maternal spine (cephalocaudal axis)

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9
Q

Ideal fetal lie

A

longitudinal; parallel relation

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10
Q

True or false: if a fetal lie is longitudinal it is not breeched

A

False; breech refers to presentation

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11
Q

Fetal presentation

A

Determined by body part of fetus that enters pelvic passage first + fetal lie

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12
Q

What are the 4 general types of fetal presentation?

A
  1. cephalic: head
  2. breech: buttocks
  3. shoulder
  4. compound: another part presents first
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13
Q

Which fetal presentation can not be delivered vaginally and why?

A

Shoulder; it is associated with a transverse or oblique lie

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14
Q

Fetal position

A

Position of fetus in relation to pelvis; where is occiput aiming in pelvis

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15
Q

What is the ideal fetal position

A

right or left occiput anterior

16
Q

Fetal station

A

relationship of presenting part (head, buttocks) to imaginary line drawn between ischial spines of maternal pelvis

17
Q

Fetal engagement

A

presenting part at 0 station/level of the ischial spines is engaged
and/or
largest diameter of presenting part reaches or passes through pelvic inlet

18
Q

Why must contractions be assessed?

A

They are expected to decrease uteroplacental blood flow; could adversely affect oxygen delivery to fetus

19
Q

Contraction timing of false labour

A

irregular, not occurring close together

20
Q

Contraction strength of false labour

A

weak, not getting stronger with time or alternating

21
Q

Contraction discomfort of false labour

A

Front of abdomen

22
Q

Change in activity associated with contractions of false labour

A

Contractions may stop or slow down with walking or making a position change

23
Q

What to tell patients when suspected they are experiencing false labor?

A

Drink fluids and walk around to see if the intensity of the contractions change; if the contractions diminish in intensity after either or both stay home

24
Q

7 Premonitory Signs of Labour

A
  1. Lightening
  2. Cervical changes - Prostaglandins change cervix from long to short and thin and flexible (ripening)
  3. Bloody show
  4. rupture of membranes
  5. sudden burst of energy
  6. loss of 0.5-1kg
  7. diarrhea, indigestion, nausea, vomiting
25
Q

What occurs in the 1st stage of labor?

A

Cervical Changes 0-10cm

26
Q

What physiologic changes occur in the early 1st stage of labour?

A
  • regular mild contractions every 5-10 min
  • effacement and dilation begin 0-3cm
27
Q

What physiologic changes occur in the active 1st stage of labour?

A

Contractions increase to every 2-5min
Dilation 4-7cm
Fetus begins to descend

28
Q

What physiologic changes occur in the transition 1st stage of labour?

A

Contractions increase
Cervix effaces and dilates to 8-10cm
Rapid descend of fetus
N/V, diaphoresis, increased bloody show

29
Q

What cardiovascular changes occur in labour?

A

Increased blood pressure with each contraction

30
Q

What respiratory changes occur in labour?

A

increase O2 demand and consumption
mild respiratory acidosis

31
Q

What GI/GU changes occur in labour?

A

Bladder edema due to pressure from fetal head
Delayed motility/emptying

32
Q

What hematological and immune changes occur in labour?

A

WBC increase, glucose decrease

33
Q

Define the second stage of labour?

A

10cm to delivery of baby; equated with pushing

34
Q

What intervention occurs with the delivery of the anterior shoulder?

A

occurs with the delivery of the anterior shoulder?
3 units IV or 10 units IM oxytocin is given between 2nd and 3rd stage to contract the uterus to prevent hemorrhage and to fully expel placenta.

35
Q

Define the 3rd stage of labour

A

Delivery of baby to delivery of placenta

36
Q

What physiologic changes occur in the 4th stage of labour

A
  • increased pulse and decreased BP r/t * redistribution of blood from uterus and blood loss
  • uterus contracted between umbilicus and symphysis pubis
  • shaking chill
  • urinary retention

Obstetrics (12 decks)

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