Intrapardum Flashcards
Gynecoid
Most common , round shape, most favorable pelvis
Antropoid
Resembles pelvis of antropoid apes , oval shape
Also favorable
Least favorable pelvis
Android- resembles the male pelvis heart shape
Platypelloid- flat pelvis - flat shape
These have a big chance of not having a vag delivery
Cephalic head positions
Vertex
Military
Brow
Face
Cardinal movements
FLEXION , internal rotation
Extension
External rotation
Expulsion
First stage of labor phases
Latent
Active
Transition
Latent phase
1-3 cm & effacement occur
Sociable , excited
Mild contractions - 5 min apart
Primigravida - 1.2 cm/hr
Multi para 1.5 cm/hr
Prolonged latent phase
Primigrvida - >20 hrs
Multi para >14 hrs
Active phase
Begins at 4 cm
More dilation and internal rotation begins
Contraction 2-5 cm lasting 40-60 sec moderate intensity
Discomfort increases
Multi parts progress faster than nulipara
Increases anxiety , sense of helplessness inwardly focused
Transition phase
Cervix 8-10 cm
Fetus descends further into pelvis
Bloody show increase
Contraction very strong 1 1/2 -2 min apart lasting 60-90 sec
Women may have urge to push and bear down (Ferguson s reflex)
Leg tremors , nausea , vomiting
Woman may be irritable and lose control
Actions that were helpful are now bothering her
Easily discouraged overwhelmed panicky
May say they can’t continue
How can you correct maternal hypotension with epidural
Left lateral position
Fluid bolus of 500 ml .. and again if they are still hypotensive
Have ephedrine ready
Narcartics given during labor
Butorphannol
Fentanyl
Meperidine
Nalbuphine
Opioid antagonist
Naloxene ( narcan )
What is typically given for nausea from a narcartics
Antiemetic
Misoprostol
Not approved by FDA but still used
25-50 mcg
Vag or orally
Repeated every 6 hours
Higher the dose the likely you will have tachsystole
Once you put it in you can have oxytocin 4 hours after last dose of Misoprostol
Never use with woman who has previous uterine scar
