Labour and Birth Flashcards
What are the critical factors in labour?
The 5Ps
Passageway
Passenger
Position
Powers (physiological forces of labour)
Psychosocial considerations
How do we assess the passageway?
Pelvis:
Size- Inlet, mid pelvis, outlet
Shape- Gynecoid, android, anthropoid, platypelloid
Cervix
Vagina
Pelvic floor muscles
What 2 shapes are more suited for vaginal births?
Gynecoid and anthropoid
What are some components of the passenger?
Fetus head
Fetal attitude
Fetal lie
Fetal presentation
What do we assess regarding fetal head?
Bones not fused at suture lines, can overlap during labor (molding)
Fontanelles are useful in determining position of head:
Anterior is diamond shaped
Posterior is triangle shaped
What do we assess regarding attitude?
Flexion or extension of the fetal body and extremities
Normal posture is flexion commonly known as the fetal position
What is fetal lie?
Longitudinal (parallel to mother spine)
Transverse (perpendicular to mother spine)
How do we assess the presentation?
The body part of the fetus entering the pelvis in a single or multiple pregnancy
Cephalic
Breech
Shoulder
A transverse lie is associated with what kind of presentation
Shoulder presentation
When assessing the relationship of the maternal pelvis, and the presenting part of the fetal body, (position) the nurse considers what?
Engagement
Station
Fetal position
What is engagement?
Engagement occurs when the largest diameter of the presenting part reaches the pelvic inlet, typically happens about two weeks before term in a primigravida
What is the largest dimension of the fetal skull to pass through the pelvic Inlet in a cephalic presentation?
When the fetal head is flexed, the biparietal diameter is the largest dimension of the fetal skull
What is a station?
Relationship of presenting part to an imaginary line between ischial spines of the pelvis
Ranges from -5 to +5
In a normal pelvis, the ischial spines mark what?
The narrowest diameter, through which the fetus must pass. The ischial spines have been designated as zero station.
How do you measure the station of the fetal head while it is descending?
If the presenting part is higher than the ischial spines, a negative number is assigned, noting centimeters above zero station.
Station -5 is at the inlet, and station +4 is at the outlet.
What is the fetal position?
Expressed in a three part abbreviation in which the first letter refers to right or left side of maternal pelvis
The second letter is the landmark of the presenting part
The third letter tells whether the landmark is facing anterior, posterior or transverse
What are the options for the first letter in fetal position
Right or left side of maternal pelvis so R or L
For the second letter, what are the landmarks of the fetal presenting part?
Occiput (O)
Mentum (M)
Sacrum (S)
Acromion (scapula [Sc]) process (A)
How do you designate the third letter for fetal position?
Anterior (A), posterior (P), or transverse (T), depending on whether the landmark is in the front, back, or side of the pelvis
What is the most common fetal position?
Occiput anterior