First Stage Labor UTD Flashcards
What defines the first stage of labor?
From onset of painful contractions to full cervical dilation (10 cm).
What are signs of active labor for admission?
Regular contractions, ≥80% effacement, cervical dilation ≥4–5 cm with change.
What are the benefits and risks of early labor admission?
More interventions; may reduce maternal anxiety if managed well.
What assessments are done on initial evaluation?
Review prenatal record, assess cervix, fetal status, vitals, bleeding, membrane status.
What lab tests should be available at admission?
Hemoglobin, blood type & screen, HIV, hepatitis B/C, syphilis, GBS.
Who can consume clear fluids during labor?
Low-risk patients with adequate airway and low cesarean risk.
What are appropriate IV fluids during labor?
D5 ½ NS, NS, or LR; glucose-containing fluids reduce ketosis.
What are main options for labor pain management?
Nonpharmacologic methods, opioids, nitrous oxide, neuraxial analgesia.
When can epidural analgesia be offered?
At any cervical dilation if requested and no contraindication.
What positions are encouraged during first stage of labor?
Upright and ambulatory positions if no contraindication.
How does continuous labor support help?
Improves satisfaction, reduces intervention, enhances coping.
When is amniotomy helpful?
During augmentation or induction; not routine in normal labor.
What are risks of amniotomy?
Infection, cord prolapse, rupture of vasa previa.
What is the frequency of FHR assessment (low-risk)?
Every 30 minutes in first stage.
What is the frequency of FHR assessment (high-risk)?
Every 15 minutes in first stage.
How is uterine activity monitored?
Via external toco or internal pressure catheter if needed.
How often should vaginal exams be performed?
Every 2–4 hrs, before analgesia, with pushing urge, or FHR issues.
Why minimize vaginal exams?
To reduce risk of iatrogenic infection.
What is protracted or arrested labor?
Slow or stalled progress; affects 20% of labors.
What is precipitous labor?
Rapid labor ending in <3 hours; rare and understudied.
What routine interventions should be avoided?
Enemas, shaving, antacids, catheterization, antiseptics, antispasmodics.
What summarizes optimal management?
Admit in active labor, support preferences, pain relief per choice, monitor labor carefully.
