labor and deliver

Question 1

braxton-Hicks contractions

Answer 1

spontaneous uterine contractions late in prego not associated with cervical dilation

Question 2

lightening

Answer 2

fetal head descending into the pelvis, causing a change in the abdomens shape and sensation that the baby has become “lighter”

Question 3

ruptured membranes

Answer 3

sudden gush of liquid or constant leakage of fluid

Question 4

bloody show

Answer 4

passage of blood-tinged cervical mucus late in prego

*occures when the cervix begins thinning–> effacemnt

Question 5

true labor

Answer 5

contractions of the uterine fundus with radiation to the lower back and abdomen

*Regular & painful contractions of the uterus causes cervical dilation & fetus expulsion

Question 6

stage 1 of labor

Answer 6

Onset of labor (true regular contractions) to full dilation of cervix @ 10 cm

Question 7

what are the two phase of stage 1 labor?

Answer 7

Latent Phase → 1-6 hrs→ Cervix effacement with gradual cervical dilation

Active Phase → 4-6 hrs → Rapid cervical dilation → Usually beginning @ 3-4 cm

Question 8

stage II of labor

Answer 8

1-2 hrs → Time from full cervical dilation until delivery of the fetus

Question 9

phases of stage II labor

Answer 9

Passive Phase → Complete cervical dilation to active maternal expulsive efforts

Active Phase → From active maternal expulsive efforts to delivery of the fetus

Question 10

stage III of labor

Answer 10

Postpartum until delivery of placenta → 0-30 minutes (avg 5)

Question 11

what are 3 signs of placental separation?

Answer 11

Gush of blood
Lengthening of umbilical cord
Anterior-Cephalad Movement of uterine fundus (becomes globular and firmer) after the placenta detaches

Question 12

how is the placenta expulsed?

Answer 12

Due to downward pressure of the retroplacental hematoma, uterine contractions

Question 13

stage IV of labor

Answer 13

eriod 1-2 hours after delivery where mother is assessed for complications is sometimes called the 4th stage

Question 14

cardinal movements of labor?

Answer 14

engagement
Flexion
descent
internal rotation
extension
external roation

Question 15

what is engagement of the fetus?

Answer 15

when the fetal presenting part enters the plevis

Question 16

what is fetal flexion

Answer 16

flextion of head to allow the smallest diameter to present to the pelvis

Question 17

what is descent?

Answer 17

passage of the head into the pelvis (lightening”)

Question 18

what is internal rotation?

Answer 18

Fetal vertex moves from the occiput transverse position to position where the sagittal suture is parallel to the anteroposterior diameter of the pelvis

Question 19

what is extension?

Answer 19

vertex extends as it passes beneath the pubic symphysis

Question 20

what is external rotation?

Answer 20

fetus externally rotatesafter the head is delivered so that the shoulder can be delivered

Question 21

what needs to be monitored during labor?

Answer 21

maternal pulse and BP (every 2-4 hrs)

maternal fluid balance

fetal monitoring (every 30 mins during the first stage, then every 15 during 2cd stage)

uterine contractions (via palpationa, tocodynamometer, or internal pressure catheter

progress of labor (cervis)

Question 22

monitoring the cervix during labor during latent phase

Answer 22

(especially when the membranes are ruptured) vaginal examinations should be done sparingly to decrease the risk of intrauterine infection

Question 23

monitoring the cervix during labor during active phase

Answer 23

Cervix should be assessed approximately every 2 hours → The cervical effacement and dilatation and the station and position of the fetal head should be recorded

Question 24

postpartum monitoring?

Answer 24

maternal blood pressure, pulse rate, and uterine blood loss must be monitored closely first hour after delivery

Question 25

what is the APGAR score?

Answer 25

A- appearance
P-pulse
Grimace (reflex irritability)
Activity
Respiration

Question 26

Appearance score

Answer 26

0- blue-gray, pale
1-acrocyanosis (body pink but extremities blue)

2- pink baby, no cyanosis

Question 27

Pulse score

Answer 27

0: 0
1: <100
2: >/= 100

Question 28

grimace

Answer 28

0: no response to stimulation
1: grimaces feebley
2: pulls away

Question 29

Activity (

Answer 29

muscle tone

0: none
1: some flexion
2: flexes arms and leges, resists extension

Question 30

Respiration

Answer 30

0: absent
1: weak, irregular
2: strong, crying (30-60/min)

Question 31

how often is APGAR scored?

Answer 31

1 & 5 minutes after birth → Repeated at 10 minutes if abnormal

Question 32

how is apgar scored?

Answer 32

Score from 1-10
> 7 → Normal
4-6 → Fairly Low
< 3 → Critically Low

Question 33

what is puerperium?

Answer 33

6 wk period after delivery

Question 34

what does the uterus do after delivery?

Answer 34

At the level of the umbilicus after delivery → Involution (shrinks) after 2 days → Descends into pelvic cavity ~2 wks → Normal size around 6 wks postpartum

Question 35

what is the lochia serosa?

Answer 35

Pinkish/brown vaginal bleeding especially postpartum days 4-10 → From the decidual tissue → Usually resolves by 3-4 weeks postpartum

Question 36

breast/menstruation in the puerperium?

Answer 36

Breast milk in postpartum days 3-5 bluish white → If lactating, mothers may remain anovulatory during that time
If not breastfeeding → Menses may return 6-8 weeks postpartum