Intrapartum Labor Flashcards
What are 6 labor triggers?
Release of prostaglandins, increased estrogen, decreased progesterone, increased oxytocin, aging of the placenta, fetal cortisol production
Maternal factors for labor triggers
Stretching of uterine muscles, estrogen/progesterone changes, oxytocin release, release of prostaglandins
Fetal factors that trigger labor
Fetal cortisol changes, placenta ages, prostaglandins increase causing contractions
7 signs of labor
Lightening, Braxton Hicks contractions, cervical changes, GI changes, backache, bloody show, SROM Occurs
The 5 P’s affecting labor
Powers, passage/passageway, passenger, psyche, position
What 3 things should be monitored for contractions?
Frequency, duration, and intensity
What does a mild, moderates or strong contraction feel like?
Mild= tip of nose, moderate= finger to chin, strong=touch forehead
What are uterine contractions responsible for?
Dilation and effacement (thinning) of the cervix in the 1st stage of labor
Planes of the true pelvis
Inter, mid pelvis or cavity, and outlet
4 types of shapes to pelvis
Gynecoid= round, anthropoid= oval shaped, android= heart, platypelloid= flat shaped
What is the optimal shape of the pelvis? Which one is also favorable for a vaginal delivery?
Gynecoid= optimal, anthropoid is also favorable
3 types of fetal presentation
Cephalic, breech, or shoulder
How is a fetal position written?
1st letter: right or left in relation to mother’s pelvis
2nd letter: fetal presenting part (O=occiput, S=sacrum, M= mentum or chin, SC = scapula/shoulder)
3rd letter: location of presenting part in relation to a portion of maternal pelvis (A= anterior, P= posterior, T= transverse)
What is the first stage of labor?
Onset of contractions to full dilation of cervix
dilation of cervix in latent, active, and transition phases
Latent: 0-6 cms
Active: 6-8 cms (fetal decent)
Transition: 8-10 cms
What is the second stage of labor?
Full dilation to birth of fetus
What is the 3rd stage of labor?
Birth and delivery of the placenta
Fourth stage of labor
Lasts about 4 hours after delivery. Most literature says next six weeks
Where are true contractions felt? false contractions?
True: felt in lower back, radiates to lower portion of abdomen
False: felt above umbilicus in abdomen
What are indications that a woman is in the latent phase of the first stage of labor?
Contractions every 5- 15 minutes
Duration of contractions: 10-30 seconds
Intensity of contraction: mild
Mom may be talkative, eager, and anxious
What are indications that a woman is in the active phase of the first stage of labor?
Contractions are moderate to strong in intensity and are every 3-5 minutes and last 30-45 seconds each
Mother feels helplessness, pain, restlessness, anxiety, serious, more inward
What are indications that a woman is in the transition phase of the first stage of labor?
Contractions are strong and come every 1-2 minutes and last 40-60 seconds (up to 90)
Mother is in pain and may feel tired, irritable, restless, out of control, panic, may have nausea/vomiting and leg cramps
Indications of stage 2 of labor
Strong Contractions every 1-2 minutes that last 50-90 seconds
Increase in bloody show
Urge to bear Down
Perineal burning/stretching
Where should the head of the bed be during delivery?
As upright as possible, at least 45°
If a membrane is ruptured, how long do you have until the infant should be delivered?
18-24 hours
Why does a baby need to be delivered after the ROM?
Infection chance increases
How do you know that the placenta is going to deliver?
Fundus rises, cord elongates, there are spurts of blood
What is shoulder dystocia considered?
A medical emergency
Can a vaginal delivery continue with a prolapsed cord?
No
