LEC51: Labor & Delivery Flashcards
defn of childbirth?
process by which fetus, placenta/membranes are expelled form uterus
defn of labor
uterine contractions that result in dilation of cervix and expulsion of fetus and placenta
what triggers labor?
not totally known
do know interaction btwn fetus, mom matters
many theories that hormones ie fetal hypothalamus, cortisol from adrenal cortex, estrogens cause labor
structure of uterus, why matters re: labor and birth?
uterus is very muscular structure
has to contract and thus expel baby and membranes
how does uterus position change over time (from non-pregnant - mid-pregnancy - fullterm)?
non-pregnant: uterus in anteverted position
~20 weeks: uterus at level of umbilicus
most pregnant: uterus expands, compresses stomach/intestines
relationship between uterus position/weeks of pregnancy?
1 cm form pubic symphysis > top of uterus per 1 week gestation
why do many pregnant women have heartburn?
when uterus compresses stomach, can cause reflux
acid in stomach can go to esophagus
woman eperiences heartburn
myth or fact: if pregnant woman has heartburn baby is hairy
myth
oxytocin function/genesis
hormone that induces labor
released by neurohypophysis of pituitary gland
estrogens function in labor
increase myometrial contractile activity
stimulate release of oxytocin & prostaglandins
how many stages of labor
3
what is 1st stage of labor
onset of labor to full dilation
12 hrs in nulliparas
7 hrs in multiparas
what is 2nd stage of labor
from full dilation to delivery
woman actively PUSHING
50 min in nulliparas
20 min in multiparas
what is 3rd stage of labor
expulsion of placenta, after baby’s delivered
~15 minutes
what is this called, when does it occur?
2nd stage of labor
crowning / delivering of baby’s head
what is turtle sign
aka shoulder dystocia
if baby’s head comes out, and then goes back in
obstetrical emergency - extremely dangerous
can have terrible consequences b/c shoulder can be stuck behind pubic bone
complications during 1st stage of labor?
1) arrest of dilation
2) arrest of descent
complications of labor/delivery during 2nd stage?
shoulder dystocia - turtle sign
complications of labor/delivery during 3rd stage?
1) retained placenta (placenta doesn’t come out)
2) placenta accreta/increta/percreta
3) uterine inversion
4) post-partum hemorrhage > lacerations, uterine atony
what is placenta acreta
if placenta invades abnormally into endometrium; can invade, and not come out
may even reach into myometrium, go through it, invade bladder/adjacent structures
more common if woman has prior uterine surgery - ie prior c-section
what is uterine atony
uterus not well-developed
what’s notable about fetal heart rate
110-160 bpm - much faster than adult
don’t want to see decelerations in fetal heart rate
category I = normal tracing of fetal heart beat
what is pitocin
synthetic hormone, inducs labor contractions
what is episiotomy?
cut perineum between vagina & rectum
helps baby come through w/o mother tearing
