Labor and Delivery Flashcards
what is phase 0 of labor?
functional quiescence
what are the uterine inhibitors in phase 0 of labor?
progesteron relaxin and NO
what is phase 1 of labor?
myometrial activation
what changes are seen in myometrium in phase 1 of labro?
contraction associated proteins are formed and increased connexin 43 for more gap junctins
what is agent that signals for uterus to wake up in phase 1?
uterotropins
after uterine wakes up in phase 1 of labor, what happens in phase 2?
uterus is stimulated
what things stimulate uterina activity?
prostaglandins E2 nd F2a and oxytocin
what must there be for contractions to occur?
Ca2+ intracellular because needed for myosin light chain kinase activiyt
what are the seven movements of labor?
engagement descent flexion internal rotation extension restitution expulsion
what is definition of engagement in labor?
largest transverse diameter of fetal head passes through the pelvic inlet
what are the three lies of babies?
vertex
breech
shoulder
what is vertex lie?
head first
what is breech lie?
legs/butt first
what two lies mean you need c section?
breech and shoulder
what is the first stage of labor in the cervix?
ripening/softening of cervix…collagen breaks down and you get dilation and effacement
what is second stage of labor?
pushing once complete cervical dilation up until expulsion of baby
what is third stage of labor?
expulsion of placenta
in intrapartum fetal monitoring, what happens with contractions?
can get decelerations of fetal heart rate
what is an early deceleration in intrapartum fetal monitoring associated with?
these are benign…regular autonomic response to compression of fetal head
what is a late deceleration in intrapartum fetal monitoring associated with?
reflex to transient hypoxia and is thought to be caused by uteroplacental insufficiency
what are variable decelerations in intrapartum fetal monitoring associated with?
cord compressions
what is an acceleration in intrapartum fetal monitoring associated with?
normal!!
what is the mnemonic to remember the decelerations and associations in intrapartum fetal monitoring?
VEAL-CHOP Variable decel Early decel Accel Late accel/decel
Cord compression
Head compression
Okay
Placental insufficiency
what is the name of the group B strep bug to worry about?
strep agalactiae
what do we give to help decrease transmission of GBS?
prophylactic penicillin
how does baby get GBS from mom
can be in genital tract and will get it during delivery
what are the seven layers of fascia in order that you go through for C section?
skin subQ fascia superficial camper and scarpas fascia rectus sheath transversalis fascia peritoneal adipose tissue peritoneum
what is within the rectus sheath that you go through for C section?
aponeurosis of external oblique, internal oblique and the transversus abdominis muscle
what is used to ripen cervix in induced labor?
PGE2 (dinoprostone) and PGE1 (misoprostil)
what is given to induce contractions in labor?
oxytocin
what do post term pregnancies have higher risk of?
neonatal mortality
