Intrapartum Part 1 Flashcards
5 P’s of Labor?
Passageway, Passenger, Powers, Position of Mother, Psych response.
What is the False Pelvis?
Above the brim
True Pelvis?
Measurement of pelvic adequacy
Where is the pelvic inlet?
Upper margin of pubic bone (public symphysis to spine)
Where is the Midpelvis?
Short, anterior wall, and along the curve of the coccyx (Symphysis to coccyx)
Where is the Pelvic outlet?
Space between the coccyx and ischial tuberosities
What are the different Pelvis shapes and how do they look?
Gynecoid?
Android?
Anthropoid?
Platypelloid?
Gynecoid (Circular, good for birth, 50% of women)
Android? (Heart shape, needs assistance with birth)
Anthropoid? (Oval - vertical, needs assistance with birth)
Platypelloid? (Oval - horizontal, c section)
What are fontanels, where are they, signs of dehydration or hypervolemia?
Fontanels are soft strucutres that allow for the skull to move, you have an anterior and posterior. Sunken is a sign of dehydration and bulging is a sign of hypervolemia.
What is Fetal Lie? 2 Different Types?
Described as “relation of cephalocaudal lie of fetus in relation to the mother”
The two different types are longitudinal, head up and down
And transverse, head facing transverse, may require c-section
What fetal attitude is expected?
Flexed appendences, chin to chest, arm across chest, legs flexed, deviations of head sizes present as issues for head of pelvis.
Complete Flexion vs Full Extension
Complete Flexion, head flexed towards chest during presentation
Full Extension, head facing towards vaginal canal during presentation.
Fetal Presentation types:
Cephalic or Vertex?
Breech?
Shoulder
Cephalic or Vertex, head exposed, 95% of time
Breech, butt or lower extremity
Shoulder, represents a transverse lie
Fetal positioning quadrants rules
Occipital? Most common?
3 Notations
The infant is always assessed based on where the occipital bone is facing.
Generally OA,
You can use R and L, O for the occiput, A for Anterior, P for posterior, or T for transverse.
Favorable positions
Mid positions
Bad positions
ROA, LOA, Favorable
ROP, LOP, Can cause issues
ROT, LOT, Baby facing wrong way
How are contractions usually?
Rhythmic, intermittent w/ relaxation between contractions
Phases of contractions?
What follows Decrement?
Increment - Rising
Acme - Peak of intensity
Decrement - Decrease
Interval phase follows decrement, relaxation of uterus.
Characteristics of contraction
Duration (seconds)
Frequency (Frequency between increment stages in minutes)
What are the primary powers of labor?
Effacement, disappearance of internal os and cervical canal. (Thinning of cervix)
Dilation , widening of cervical os and cervical canal to 10cm
What is station and how it is measured?
Station is the position as the baby as it enters the the vaginal canal, it’s measured by how far out or far in the baby’s head is presenting.
How is dilation/effacement/station notated?
Dilation/effacement/station
Ex: 2/50/-1
Secondary Powers of Labor?
Pushing when cervix is completely dilated, can cause damage if pushing is done before
Valsalva - Holding the breath during pushing, not the best because it reduces oxygen flow to mother and fetus
What is Valsalva?
Holding the breath during pushing, not the best because it reduces oxygen flow to mother and fetus
Benefits of upright birthing positions?
Gravity assists with fetal descent, facilitates dilation of effacement, reduces pressure on major maternal structures
Benefits of Lateral birthing (side-lying)
Increases cardiac output, improves perfusion to organs, removes pressure, helps with back pain and help with back pain facilities counterpressure
