Intrapartum Labor

Question 1

What are 6 labor triggers?

Answer 1

Release of prostaglandins, increased estrogen, decreased progesterone, increased oxytocin, aging of the placenta, fetal cortisol production

Question 2

Maternal factors for labor triggers

Answer 2

Stretching of uterine muscles, estrogen/progesterone changes, oxytocin release, release of prostaglandins

Question 3

Fetal factors that trigger labor

Answer 3

Fetal cortisol changes, placenta ages, prostaglandins increase causing contractions

Question 4

7 signs of labor

Answer 4

Lightening, Braxton Hicks contractions, cervical changes, GI changes, backache, bloody show, SROM Occurs

Question 5

The 5 P’s affecting labor

Answer 5

Powers, passage/passageway, passenger, psyche, position

Question 6

What 3 things should be monitored for contractions?

Answer 6

Frequency, duration, and intensity

Question 7

What does a mild, moderates or strong contraction feel like?

Answer 7

Mild= tip of nose, moderate= finger to chin, strong=touch forehead

Question 8

What are uterine contractions responsible for?

Answer 8

Dilation and effacement (thinning) of the cervix in the 1st stage of labor

Question 9

Planes of the true pelvis

Answer 9

Inter, mid pelvis or cavity, and outlet

Question 10

4 types of shapes to pelvis

Answer 10

Gynecoid= round, anthropoid= oval shaped, android= heart, platypelloid= flat shaped

Question 11

What is the optimal shape of the pelvis? Which one is also favorable for a vaginal delivery?

Answer 11

Gynecoid= optimal, anthropoid is also favorable

Question 12

3 types of fetal presentation

Answer 12

Cephalic, breech, or shoulder

Question 13

How is a fetal position written?

Answer 13

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)

Question 14

What is the first stage of labor?

Answer 14

Onset of contractions to full dilation of cervix

Question 15

dilation of cervix in latent, active, and transition phases

Answer 15

Latent: 0-6 cms
Active: 6-8 cms (fetal decent)
Transition: 8-10 cms

Question 16

What is the second stage of labor?

Answer 16

Full dilation to birth of fetus

Question 17

What is the 3rd stage of labor?

Answer 17

Birth and delivery of the placenta

Question 18

Fourth stage of labor

Answer 18

Lasts about 4 hours after delivery. Most literature says next six weeks

Question 19

Where are true contractions felt? false contractions?

Answer 19

True: felt in lower back, radiates to lower portion of abdomen
False: felt above umbilicus in abdomen

Question 20

What are indications that a woman is in the latent phase of the first stage of labor?

Answer 20

Contractions every 5- 15 minutes
Duration of contractions: 10-30 seconds
Intensity of contraction: mild
Mom may be talkative, eager, and anxious

Question 21

What are indications that a woman is in the active phase of the first stage of labor?

Answer 21

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

Question 22

What are indications that a woman is in the transition phase of the first stage of labor?

Answer 22

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

Question 23

Indications of stage 2 of labor

Answer 23

Strong Contractions every 1-2 minutes that last 50-90 seconds
Increase in bloody show
Urge to bear Down
Perineal burning/stretching

Question 24

Where should the head of the bed be during delivery?

Answer 24

As upright as possible, at least 45°

Question 25

If a membrane is ruptured, how long do you have until the infant should be delivered?

Answer 25

18-24 hours

Question 26

Why does a baby need to be delivered after the ROM?

Answer 26

Infection chance increases

Question 27

How do you know that the placenta is going to deliver?

Answer 27

Fundus rises, cord elongates, there are spurts of blood

Question 28

What is shoulder dystocia considered?

Answer 28

A medical emergency

Question 29

Can a vaginal delivery continue with a prolapsed cord?

Answer 29

No