Labor Flashcards
6 PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
Lightening
Weight Loss
Increase Energy/ Activity Level
Braxton Hicks
Ripening of the Cervix
Rupture of Membranes
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
Settling or descent of the fetal head into the
pelvic inlet, experience of “dropping” of the
baby (it happens 2 weeks before EDC)
Lightening
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
why do they loss 1-3 pounds; 1-2 days; prior to labor onset
because of the decrease of
progesterone, may decrease in fluid
retention
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
1-2 days prior to labor onset
why there is an increase in energy and activity level
; because of the increase of adrenaline
for the work ahead
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
- irregular painless “practice” contractions
- -during at night
- usually confine at abdomen only
Braxton-Hicks
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
from Goodell sign to butter soft
Ripening of Cervix
PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR
labor is inevitable (labor should occur within next the 24 hours and delivery should occur within 24 hours to avoid infection)
* sa ER, ask the client to lie down, check the fetal heart rate, tell the patient to avoid, to ambulate
Rupture of Membranes
4 SIGNS OF TRUE LABOR
- Uterine contractions
- Cervical Dilation and Effacement
- Pain in the back that radiates around to the abdomen
- Bloody Show/Show
SIGNS OF TRUE LABOR
- surest signs of labor onset
- it occurring during regular intervals and
increases in duration and intensity, the
intensity usually occurs in walking
Uterine Contractions
SIGNS OF TRUE LABOR
enlargement of external cervical
os up to 10 cm as a result of uterine
contractions and because of pressure of both presenting part and bag of water
Dilation
SIGNS OF TRUE LABOR
- shortening and thinning of the
cervical canal from 1 to 2 cm to one in which
no canal as Distinct from the uterus exist - express in percentage
- in a primipara, the cervix will first efface then, dilate; in a multipara, effacement and
dilation occur simultaneously.
Effacement
SIGNS OF TRUE LABOR
expulsion of mucus plug, labor begins 2 to 3
days after bloody show or bloody show may be observed at the onset of labor
* pressure of the descending part of the fetus causes rupture of capillaries in the mucus
membrane of cervix
- blood mixes with operculum in released
result: pinkish vaginal discharge
*if bright red, it means active ang
bleeding
Bloody Show/Show
Phases of Uterine Contractions
s the first
phase during which the intensity of
contraction Increases
Increment (Crescendo)
Phases of Uterine Contractions
the hike of the uterine
contractions
Acme (Apex)
Phases of Uterine Contractions
the last phase during which intensity contraction decrease
Decrement (Decrescendo)
2 Distinct Portions of Uterus
becomes thick and active in order to expel the fetus
- The only part that contracts
Upper Uterine Segment
2 Distinct Portions of Uterus
becomes a thin wall, supple and passive, that the fetus pushes out easily
Lower Uterine Segment
formed at the boundary of the upper and lower uterine segment
Physiological Retraction Ring
when the Fetus is larger than the birth canal the round ligament of the uterus becomes tense during expulsion, this tense will result
in the formation of abdominal indentation
Danger sign of labor
Pathological Retraction Ring (Bandal’s
Ring)
MECHANISM OF LABOR
the Fetus has reached the pelvic inlet
Engagement
MECHANISM OF LABOR
From AP to transverse, then AP to AP, fetal head rotates to
accommodate itself to changing diameter of the pelvis
Internal Rotation
MECHANISM OF LABOR
as descent occurs, pressure from
the pelvic floor causes the fetal chin to bend towards the chest
Flexion
MECHANISM OF LABOR
fetus goes down the birth canal
Descent
MECHANISM OF LABOR
as head comes out, the back of
the neck beneath the pubic arch l, the head
extends and the forehead, nose, mouth the chin
appear
Extension
MECHANISM OF LABOR
the delivery of the rest of the
baby’s body
Expulsion
1ST STAGE OF LABOR
begins with onset of the regular contractions and ends with complete dilation and effacement
CERVICAL DILATION
MECHANISM OF LABOR
anterior shoulder rotates externally to the AP position so that it is just behind the symphysis pubis
External Rotation (Restitution)
2ND STAGE OF LABOR
begins with complete Cervical dilation and effacement and ends with delivery of the Fetus
EXPULSION
3RD STAGE OF LABOR
begins immediately after Fetus is born and ends when the placenta is delivered
PLACENTAL STAGE
STAGE OF CERVICAL
DILATION
Cervical Dilation: 0-3 cm
Cervical effacement in primipara is usually complete before dilatation; in multipara, it occurs with dilatation
Duration: 8-10 hours
Uterine contractions are mild, 5-30 minutes apart, and last 10-30 seconds
Membranes ruptured or intact
Scant brown or pink vaginal discharge or mucus plug
Station: primipara usually 0; multipara -2 to 0
FHR: clearest at level or below umbilicus (dependent on fetal position)
Woman’s reaction: alert, talkative, nervous, excited with some degree of apprehension but still with ability to communicate
Breathing techniques: deep chest or abdominal breathing
Latent Phase
4TH STAGE OF LABOR
begins after the delivery of the placenta and continues for 1-4 hours after delivery
MATERNAL
HOMEOSTATIC STABILIZATION STAGE
STAGE OF CERVICAL
DILATION
Cervical Dilation: 8-10 cm
Duration: 1-2 hours
Uterine contractions are strong, 2-3 minutes apart, last 45-60 second
Copious bloody mucus
Station: +2, +3
FHR: clearest directly about symphysis pubis
Woman’s reaction: mood suddenly changes, fatigue, perhaps nauseated
If spontaneous BOW rupture does not occur, Amniotomy (snipping of BOW with a sterile pointed object) is done to let AF drain out, preventing fetus from aspisting AF into lungs
Breathing Techniques: high chest, pant blow breathing
Presence of uncontrollable urge to push with contractions so profuse perspiration and
neck vein distention are seen
Transition Phase
STAGE OF CERVICAL
DILATION
Cervical Dilation: 4-7 cm
Duration: approximately 6 hours
Uterine contractions are moderate, 3-5 minutes apart, last 30-45 seconds
Scant to moderate bloody mucus
Station: 0 to +1
FHR: heard slightly below umbilicus or lower abdomen
Woman’s reaction: with fears of losing control of self, becoming less outgoing, more introverted, concentrating on breathing patterns
Breathing techniques: accelerate shallow panting (pant-shallow rapid respirations)
Active Phase
