Labor and Delivery Lecture Powerpoint Flashcards
3 stages of labor
1) begins with onset of contractions and ends when cervix is fully dilated
2) complete dilation of cervix and delivery of infant
3) delivery of infant to delivery of placenta and membranes
3 clinical signs of onset of labor
-cervical changes “bloody show”
-contractions
-
3 clinical signs of onset of labor
- cervical changes “bloody show”
- contractions
- rupture of membranes
Contractions of labor
Painful physiologically unique muscular contractions involuntary and independent of extrauterine control
Pushing during labor
Increased intraabdominal pressure from mother using valsalva assists in the involuntary uterine contractions
Cervical effacement and cervical dilation
Shortening of the cervical canal from 2cm to paper thin edges
Stretching open of cervix from a few milimeters to 10 cm
The cervix dilates from the…
….inside down outward
Changes to the vagina and pelvic floor during labor
Levator ani muscles thinned to less than 1mm, perineum thinned to nearly paper thin
Placental separation in labor
Uterine contraction reduces area of placental implantation causing expulsion by uterine contraction
3 geographical descriptions of the fetus
Fetal lie (longitudinal or transverse (sideways baby)) Fetal presentation (cephalic, breech, or shoulder) Fetal position (left or right, and if posterior fontanelle is anterior or posterior) (LOA ROA LOP ROP)
Frank breech vs incomplete vs complete
Frank has ankles to ears, incomplete has one knee bent, complete is both knees are bent
In the case of premature labor, ___ presentation is much higher
breech
Leopold maneuvers
2 handed (except for the 3rd) series of 4 maneuvers on the pregnant womans stomach, helpful in determining head and rear location for auscultation of fetal heart rate
Cardinal movements of labor (9)
- Engagement (lowest part of head passes thru the pelvic inlet, can be palpated at the ischial spine, eyes face left or right hip)
- descent (head descends thru pelvis due to pressure of amniotic fluid, maternal pushing, fundus pressuring breech, and extension and straightening of fetal body)
- flexion (descending head meets resistance from pelvic floor causing flexion of fetal chin upon thorax, if brows are presenting in extension typically cannot be delivered)
- internal rotation (pressure of presenting part against pelvic structures rotates head OA or OP)
- extension (occurs when head reaches vulva, extending and popping out)
- external rotation (head turns to the left or right - restitution)
- expulsion (get this shit out of me)
These are all fluid and occur together
Caput succedaneum
Edema of he fetal scalp in the portion immediately over the cervical os, normal compression of the fetal head from external compressive forces allows for delivery (molding)
