Labor Flashcards
Indication for induction of labor:
Postterm labor, DM, IUGR, nonreassuring fetal test and preeclampsia
How high Bishop score is needed to achieve successful induction of labor?
5 or higher
What to do with patient with a bishop score lower than 5 that need induction?
Cervical ripening: prostaglandin E2 (PGE2) gel, PGE2 pessary (Cervidil), or PGE1M (misoprostol)
Contraind for use of prostaglandin?
maternal: asthma and glaucoma
obstetric: prior cesarean delivery and nonreassuring fetal testing
What other procedures can be made to induce labor and what are the precaution here?
amniotomy (puncture of amniotic sac to release fluid)
caution: ensure no prolapse of umbilical cord
Augmentation is done how?
With oxytocin and amniotomy. Same indication + inadequate contractions or a prolonged phase of labror.
What is normal range of fetal heart?
110-160 bpm
What can cause fetal HR above 160 bpm?
The concern is infection, hypoxia or anemia.
What types of decelerations is it?
Early, variable and late
What is the decelerations caused by?
- Early: Result of increased vagal tone secondary to head compression during a contraction.
- Variable: result of umbilical cord compression
- Late: These are result of uteroplacental insufficiency
Which of the decelerations is most worrisome and why?
late because they may degrade into bradycardias as labor progresses
What are the cardinal movements of labor?
Engagement, descendent, flexion, internal rotation, extension and external rotaion (also called restitution or resolution)
How long is the avarage first stage?
10-12hr in nulliparous
2-12 hr in multiparous.
When is latent phase and what characterize it?
Onset to cervical dilation of 6 cm. Characterized by slow cervical changes.
When is active phase?
From latent until complete dilation.
