Labor Anesthesia & Analgesia Pt. 1 (Exam 3) Flashcards by Andrew Everett

What does primip and multip stand for?

Primip: primiparous, given birth to one child >20wks
Multip: multiparous, delivered more than one child >20wks

How well did you know this?

Not at all

Perfectly

What does SROM stand for?

Spontaneous Rupture of Membranes

How well did you know this?

Not at all

Perfectly

What does AROM stand for?

Artificial Rupture of Membranes

Also known as Amniotomy.

How well did you know this?

Not at all

Perfectly

What does OA and OP stand for? Which is preferred for delivery?

OA: Occiput Anterior (back of baby head facing forward)
OP: Occiput Posterior (back of baby head facing back)

OA (Occiput Anterior) is preferred for delivery

How well did you know this?

Not at all

Perfectly

What is CLE, DPE, and CSE?

CLE: continuous labor epidural
DPE: dural puncture epidural
CSE: combined spinal epidural

How well did you know this?

Not at all

Perfectly

What do the numerics mean in G2 P0101?

Gravida 2 pregnancies including current
Para
0: term (37wk+)
1: preterm
0: abortions (miscarriage or loss)
1: living children

How well did you know this?

Not at all

Perfectly

The amniotic sac serves what purposes?

helps protect uterine contents from bacteria
provides mechanical protection/cushion for fetus and umbilical cord

How well did you know this?

Not at all

Perfectly

Once the amniotic membranes rupture (spontaneous or artificial), how quickly does birth need to take place? Why?

After rupture, birth needs to take place within 12 hours because of risk of infection

How well did you know this?

Not at all

Perfectly

How long will the first stage of labor last for a woman having her first baby?

If Primiparous, 8 - 12 hours typically.

How well did you know this?

Not at all

Perfectly

How long will the first stage of labor last for a woman having already had a child before?

If Multiparous, 5 - 8 hours typically.

How well did you know this?

Not at all

Perfectly

What are the two phases of the first stage of labor?

Latent Phase
Active Phase

How well did you know this?

Not at all

Perfectly

What characterizes the Latent phase of labor?

Cervical Effacement (thinning)
Minor cervical dilation (2-4cm)
Contractions q5-7 min w/ 30 sec duration

How well did you know this?

Not at all

Perfectly

What characterizes the active phase of the first stage of labor?

Cervical dilation up to 10cm/complete
Contractions q2-5min w/ 60sec duration

How well did you know this?

Not at all

Perfectly

How long does the 2ⁿᵈ stage of labor last?

Typically 15 - 120 min

How well did you know this?

Not at all

Perfectly

What characterizes the 2ⁿᵈ stage of labor?

Full (10cm) cervical dilation
Contractions q 2min w/ 60-90s duration
Fetal Descent
Ends with Delivery

How well did you know this?

Not at all

Perfectly

What event characterizes the end of the 2ⁿᵈ stage of labor?

Fetal Delivery

How well did you know this?

Not at all

Perfectly

The 2ⁿᵈ stage of labor is considered prolonged if it lasts more than….

3 - 4 hours

How long does the 3rd stage of labor last?

15 - 30 min

When does the 3rd stage of labor begin?

Begins after fetal delivery

The 3rd stage of labor is prolonged if it lasts more than ….

30 minutes

What marks the end of the 3rd stage of labor?

Delivery of the placenta

In what stage of labor is the highest risk of uterine atony and post-partum hemorrhage present?

4th stage (1 hour postpartum)

When does the 4th stage of labor occur?

1 hour post-partum

What causes pain via mechanoreceptor stimulation in the 1st stage of labor?

Stretching and distention of lower uterine segment and cervix

What transmits the visceral pain associated with the 1st stage of labor?

C-fibers entering spinal cord at T10 - L1

What type of pain is hard to localize, generally in the lower abd, sacrum, and back; and can be difficult to treat with opioids?

visceral pain

What spinal levels are primarily affected during the latent phase of the 1st stage of labor?

T10 - T12

What spinal levels are primarily affected during the active phase of the 1st stage of labor?

T12 - L1

Painful stimulation from T10-L1 is typically felt in what stage of labor?

stage 1

What type of pain becomes more predominant in the 2ⁿᵈ stage of labor? What are the characteristics of this pain?

Somatic Pain - Sharp, easily localized - Caused by stretching & compression of pelvic/perineal structures

What nerve fibers are responsible for the somatic pain characteristic of the 2ⁿᵈ stage of labor?

Aδ fibers of the pudendal nerve

What spinal levels are relevant to the somatic pain associated with the 2ⁿᵈ stage of labor?

T12 - S4

What is a "doula"?

* support person * often non-medical * offer emotional and physical support

What inhaled anesthetic can a patient use to "self-anesthetize"?

N₂O (Nitronox)

What receptors does N₂O work on?

- Inhibits: NMDA glutamate receptors - Stimulates: dopaminergic, opioid, and αlpha 1&2 receptors

How much does N₂O depress uterine contractility?

Trick question. It does not.

Does N₂O causes neonatal depression?

What nerve block is often used in conjunction with N₂O ?

Pudendal nerve block

What are adverse effects associated with N₂O?

* N/V * Dizziness * Paresthesias * Xerostomia (dry mouth) .

Combination of N₂O and _______ can result in hypoxia, LOC changes, and loss of airway reflexes.

Opioids

Volatile anesthetic agents will cause uterine smooth muscle ________ in a dose-dependent modality.

uterine smooth muscle **relaxation**