L&D Flashcards
engagement
fetal presenting part widest diameter reaches level of the ischial spines of mother’s pelvis
Extension
fetal head passess beneath the mother’s symphysis pubis
internal rotation
allows the largest fetal head diameters to match largest maternal pelvic daimeters
external rotation
- allows shoulders to rotate internally to fit mom’s pelvis
maternal factor that can inhibit fetal descent
a full bladder
normal FHR
110-160 bpm
fetal tachycardia
> 160/min for 1 min
fetal bradycardia
< 110/min for min or longer
4 Ps
Powers, passageway, passenger, psyche
Tachysystole
Contractions too frequent ( every 2 Mom), too long (>90-120 sec), minimal rest < 30 sec
Pain med that does not affect fetus
Nitrous oxide
Nuchal
Umbilical cord interrupted because of being wrapped around the neck
Reassuring FHR
- average FHR 110-160
- regular rhythm
- accelerations from baseline rate
- no decrease in rate from baseline
Non reassuring FHR
- HR outside normal limits unexplained tachy or brady
- irregular rhythm
- gradual abrupt decrease in rate
Bishops score
- cervical dilation
- length of cervix
- stationing if presenting part
- consistency
- position
Dystocia
Prolonged difficult labor
Tocolytic med
Relax uterus , slows delivery
Caput succedaneum
Swelling of the scalp
Normal wbc level for Mom
14-16k
25k + not good
Expected fetal response to active fetal movement is
Acceleration of at least 15 bpm for 15 seconds
Tocotransducer
On Fundus, records uterine contractions
Ultrasound transducer
Over abdomen, measures FHR pattern
Normal infant scalp ph
7.25-7.35
Biophysical profile
- FHR
- Fetal breathing movements
- Gross body movement
- Fetal tone
- Qualitative amniotic fluid volume
Pt with hydramnios, after amniotomy, risk for ____________ increases
Abruptio placentae because the uterus is distended r/t hydramnios
Average blood loss during birth
500 ml
Clotting factors during labor
Increased so is DVT risk
Fetal protective factors
IncreAsed HMG, HCT & CO
Normal fetal presentation
vertex
Normal fetal attitude
Flexion head towards chest , arms flexed over thorax , back curved like convexshape
Most important characteristic about true labor
Progressive effacement and dilation of the cervix
Shultze
Shiny fetal surface of placenta
Duncan
Dull maternal surface of placenta
4 stages of labor
- Cervical dilation and effacement
- Expulsion of fetus
- Expulsion of placenta
- Maternal physiologic stabilization and parent-infant bonding
IPC
Only way to measure accurate resting tone and intensity of contractions
Intrauterine pressure catheter
