Labor

Question 1

component of the first stage of labor

Answer 1

latent phase: uterine contractions that cause cervical change - 4cm (now 6cm)

active phase: rapid dilation. begins at 4cm(6cm now) and ends at 10cm.

Nulliparous woman: 20 hours

multiparous woman: 14 hours.

rate of cervica dilation:

1. nulliparous - 1.2cm/hr
2. multiparous - 1.5cm/hour

Question 2

what is the second stage of labor?

Answer 2

second stage of labor - second stage of labor is stage of fetal expulsion

10cm - fully dilated and ends with delivery of the fetus

Question 3

third stage of labor

Answer 3

placental separation - from delivery of fetus —>delivery of placenta (should last less than 30minutes)

Question 4

What are the three signs of placental separation:

Answer 4

1. gush of blood from vagina
2. umbilical cord lengthening
3. fundus of the uterus rises up and becomes firm

Question 5

true labor v false labor

Answer 5

false labor(Braxton Hicks contractions)

1. occur at irregular intervals
2. intensity remains the same
3. discomfort in lower abdomen/groin
4. no cervical chnages
5. relieved by medication

Question 6

true labor

Answer 6

occur at regular intevals

increase in intesity

discomfort in back and lower abdomen

cervix changes

NOT relieved by medications

Question 7

what are the three signs of placental separation?

1. gush of blood
2. umbilical cord lengthening
3. fundus of uterus rises and firms

Question 8

what can cause a false positive nitrazine test?

Answer 8

vaginal infections with Trichomonas vaginalis

Blood

seme

Question 9

ferning test - what is it?

Answer 9

high estrogen content of amniotic fluid causes fern pattern on slide when allowed to air dry

• crystallization/arborization is due to interaction of amniotic fluid proteins and salts
• confirms ROM in 85-95% of cases.

Question 10

nitrazine test

Answer 10

nitrazine paper is pH sensitive and turns blue in the presence of amniotic fluid

amniotic fluid pH = 7.15 = more alkalike than vaginal secretions

Question 11

what causes early decels?

Answer 11

fetal head compression

Question 12

what causes variable decels?

Answer 12

cord compression

Question 13

what causes late decels?

what do they indicate?

Answer 13

late decels suggest fetal hypoxia

and if recurrent (>50% of uterine contractions), can indicate fetal acidemia.

Question 14

what causes late decels?

Answer 14

uteroplacental insufficiency

Question 15

what are montevideo units?

Answer 15

10 minute window of contractions - look at uterine contractions.

-each contraction rise above baseline are added up and if >200Units in 10minutes then considered adequate

Question 16

what are adequate uterine contractions?

Answer 16

defined as contractions every 2-3 mintues firm on palpation, and lasting 40-60seconds

Question 17

_______________are mirror images of uterine contractions, caused by fetal head compressions

Answer 17

early decels

Question 18

_____are abrupt in decline and abrupt in resolution and are caused by cord compression

Answer 18

variable decelerations

Question 19

__________________ are gradual in shape and are offset from the uterine contractions, caused by uteroplacental insufficiency

Answer 19

late decels