INTRAA Flashcards
The first 1 to 4 hours after delivery of the newborn and placenta
Intrapartum
Refers to the medical and nursing care given to the pregnant woman during labor and delivery.
Intrapartum Care
Series of events by which uterine contractions and abdominal pressure expel a fetus and placenta from the uterus.
Labor
True or False:
Irregular contraction causes progressive dilatation of the cervix and create sufficient muscular uterine force to be pushed out into extrauterine life.
False - Regular contractions
Which theories of onset labor:
A hollow organ once stretched to its maximum potential will always contract and expel content.
Uterine Stretch Theory
Rising of fetal cortisol level reduce progesterone level which increases prostaglandin formation
Prostaglandin Theory
Increased estrogen and sudden drop in progesterone near delivery stimulates labor
Progesterone Deprivation/Withdrawal
Placenta begins to degenerate by 36 weeks where the body perceives it as a foreign body already, and make its own defense to expel it by contraction of the uterus.
Theory of Aging Placenta
The posterior pituitary gland produces oxytocin which causes contractions.
Oxytocin Stimulation Theory
Largest part of the newborn’s body and 1/4 of the newborn’s length.
Fetal head
Connects 2 parietal bones
Sagittal
Connects parietal and frontal bones
Coronal
Connects parietal and occipital bones
Lambdoidal
Overlapping of the sutures of the skull to permit passage of the head to the pelvis
Molding
Diamond in shape and measures 3x4 cm in size
Bregma (Anterior Fontanel)
Triangular in shape and measures 1x1 cm in size
Lambda (Posterior Fontanel)
Are used as landmarks for internal examination during labor to determine position of fetuses.
Fontanels
May be manipulated during delivery to allow passage.
Fetal Shoulder
Largest Transverse diameter measurement
Biparietal (9.25 cm)
Relationship of spine of fetus to spine of the mother
Lie
Fetus’ long axis parallel with mother’s long axis where 99% of cases assume this position
Longitudinal or Vertical
Relationships of fetal parts to each other
Attitude
Complete flexion, most common where head is fully flexed, chin touches sternum.
Vertex/ Occiput Position
Moderate flexion, head is moderately flexed, occipital frontal or sinciput to birth canal
Sinciput / military position
Brow to birth canal, back is arched, neck is extended
Partial Extension
Complete extension but with poor flexion, back is arched and neck is extended.
Face
Denotes the body part that will first contact the cervix or be born first. It is determined by the combination of fetal lie and the degree of fetal flexion.
Presentation
The fetal head is the body part that first contacts the cervix
Cephalic
Means either the buttocks or the feet are the first body parts that will contact the cervix.
Breech
Types of breech presentation:
- thighs rest on abdomen while legs rest in thighs
Complete breech
Type of breech presentation:
Thighs rest on abdomen while legs extend to the head
Incomplete breech: Frank
Type of breech presentation:
1 leg flexed and 1 foot is extended
Single footling
Type of breech:
2 legs un-flexed and extended
Double footling
A fetus lies horizontally in the pelvis, so the longest fetal axis is perpendicular to that of the pregnant person.
Shoulder/transverse
Relationship of the fetal presenting part to specific quadrant of the mother’s pelvis
Position
External palpation of maternal abdomen to determine fetal contour or outline
Leopold’s Maneuver
Location of sutures and fontanels to determine relationship to maternal pelvis
Vaginal Examination
To determine which quadrant that the fetal heart tone is best heard.
Auscultation of FHT
Relationship of presenting part to ischial spines denoted in centimeters
Station
Above the ischial spine, fetus is still floating and needs rest
-3 to -5 cm
Fetus is at the level of the ischial spine and is already engaged.
0 cm
Fetus is a 3 to 5 cm below the ischial spine and crowning occurs and signals the 2nd stage of labor.
+3 to +5 cm
Female pelvis, has an inlet that is well rounded forward and backward, and has a wide pubic arch. This pelvic type is ideal for childbirth.
Gynecoid
Male pelvis, the pubic arch forms an acute angle, making the lower dimensions of the pelvis extremely narrow.
Android
Apelike pelvis, the transverse diameter is narrow; the anteroposterior diameter of the inlet is larger than usual.
Anthropoid
Basis in getting the true conjugate, measures between the sacral promontory and inferior margin of the symphysis pubis and measures around 11.5 to 12.5 cm
Diagonal conjugate
Flattened pelvis, has a smooth curved oval inlet but anteroposterior diameter is shallow.
Platypelloid
Measures between the sacral promontory and superior margin of the symphysis pubis
True conjugate
Intertuberous diameter may be measured by placing a closed fist against the perineum at the level of the tuberosities.
Pelvic outlet
Transverse diameter + PSD > 1.5 cm = outlet is adequate
Thom’s rule
The force acting to expel the fetus and placenta
Power
Involuntary contractions, voluntary bearing down efforts, wave like characteristics, timing, frequency, duration and intensity
Power
Psychological stress exists when the mother is fighting the labor experience
Psyche and person
Respect the belief /religion of the members of the family
Prayer
