I Flashcards
What is labor?
Labor is a series of events in the genital organs that lead to the expulsion of a viable fetus from the womb through the vagina.
Who is a parturient?
A parturient is a patient in labor.
What is parturition?
Parturition is the process of giving birth.
What is delivery?
Delivery refers to the expulsion or extraction of a viable fetus from the womb.
What are the criteria for normal labor (eutocia)?
Spontaneous onset at term, vertex presentation, no undue prolongation, minimal aid for delivery, no complications affecting the mother or baby.
What is abnormal labor?
Any deviation from the criteria of normal labor is considered abnormal labor.
When does labor typically start?
On the expected date in 4% of cases, within 1 week before or after in 50%, 2 weeks earlier or 1 week later in 80%, at 42 weeks in 10%, at 43 weeks or more in 4%.
What are the characteristics of false labor pain?
Dull pain in the lower abdomen and groin, continuous and unrelated to uterine contractions, no effect on cervical dilation, relieved by enema or sedatives.
What are the characteristics of true labor pain?
Regular painful uterine contractions, increasing intensity and duration, ‘show’ (expulsion of the mucus plug mixed with blood), progressive cervical effacement and dilation, formation of the ‘bag of waters.’
What are the stages of labor?
First stage: onset of labor pain to full cervical dilation, second stage: full cervical dilation to fetal expulsion, third stage: expulsion of fetus to expulsion of placenta, fourth stage: observation for at least one hour post-delivery.
What is the average duration of each stage of labor?
First stage: 12 hours in primigravida, 6 hours in multipara, second stage: 2 hours in primigravida, 30 minutes in multipara, third stage: 15 minutes (reduced to 5 minutes with active management).
What are the main events in the first stage of labor?
Cervical effacement and dilation, formation of the lower uterine segment.
What are the phases of the second stage of labor?
Propulsive phase: begins with full cervical dilation and ends when the head reaches the pelvic floor, expulsive phase: begins with the head at the pelvic floor and ends with complete fetal expulsion.
What happens during the third stage of labor?
Separation, descent, and expulsion of the placenta and membranes.
What is the mechanism of labor?
A series of movements of the fetal head during its journey through the pelvis for adaptation.
What are the principal movements in the mechanism of labor?
Engagement, descent, flexion, internal rotation, crowning, extension, restitution, external rotation, expulsion of the trunk.
What is crowning?
When the biparietal diameter of the fetal head stretches the vulval outlet without recession of the head after contraction.
What is restitution?
Passive movement of the fetal head due to untwisting of the neck after internal rotation.
What is external rotation?
Visible external movement of the fetal head due to internal rotation of the shoulders.
What are the per-abdomen findings before placental separation?
Uterus becomes discoid, firm, and non-ballottable, fundal height reaches slightly below the umbilicus.
What are the per-vagina findings before placental separation?
Slight trickling of blood, umbilical cord length remains static.
What happens per-abdomen after placental separation?
Uterus becomes globular, firm, and ballottable, fundal height slightly rises, bulging in the suprapubic region.
What happens per-vagina after placental separation?
Gush of blood, permanent lengthening of the umbilical cord.
How is the placenta expelled?
By voluntary bearing down or assisted manipulative procedures.
What are maternal signs after placenta expulsion?
Chills and occasional shivering, slight transient hypotension.
What are the principles of managing the first stage of labor?
Non-interference with watchful expectancy, monitoring progress of labor, maternal condition, and fetal behavior.
What are the general management measures in the first stage?
Antiseptic dressing, encouragement and assurance, constant supervision.
Why is an enema given in the early stage?
To prevent soiling of the perineum during the second stage.
Why should a full bladder be avoided during labor?
A full bladder can inhibit uterine contractions and lead to bladder hypotonia and infection.
How is pain relief managed in the first stage?
Analgesics or inhalation pain relief.
What are the principles of managing the second stage of labor?
Assist natural fetal expulsion, prevent perineal injuries.
What are the general management measures in the second stage?
Patient should lie down, constant supervision, inhalation analgesics, vaginal examination.
What are the preparation steps for delivery?
Shift to labor table, proper positioning of the patient, aseptic precautions (scrubbing, sterile gown, gloves), external genitalia toileting, bladder catheterization if full.
What are the phases of delivery assistance?
Delivery of the head, delivery of the shoulders, delivery of the trunk.
