LEC51: Labor & Delivery

Question 1

defn of childbirth?

Answer 1

process by which fetus, placenta/membranes are expelled form uterus

Question 2

defn of labor

Answer 2

uterine contractions that result in dilation of cervix and expulsion of fetus and placenta

Question 3

what triggers labor?

Answer 3

not totally known

do know interaction btwn fetus, mom matters

many theories that hormones ie fetal hypothalamus, cortisol from adrenal cortex, estrogens cause labor

Question 4

structure of uterus, why matters re: labor and birth?

Answer 4

uterus is very muscular structure

has to contract and thus expel baby and membranes

Question 5

how does uterus position change over time (from non-pregnant - mid-pregnancy - fullterm)?

Answer 5

non-pregnant: uterus in anteverted position

~20 weeks: uterus at level of umbilicus

most pregnant: uterus expands, compresses stomach/intestines

Question 6

relationship between uterus position/weeks of pregnancy?

Answer 6

1 cm form pubic symphysis > top of uterus per 1 week gestation

Question 7

why do many pregnant women have heartburn?

Answer 7

when uterus compresses stomach, can cause reflux

acid in stomach can go to esophagus

woman eperiences heartburn

Question 8

myth or fact: if pregnant woman has heartburn baby is hairy

Answer 8

myth

Question 9

oxytocin function/genesis

Answer 9

hormone that induces labor

released by neurohypophysis of pituitary gland

Question 10

estrogens function in labor

Answer 10

increase myometrial contractile activity

stimulate release of oxytocin & prostaglandins

Question 11

how many stages of labor

Answer 11

3

Question 12

what is 1st stage of labor

Answer 12

onset of labor to full dilation

12 hrs in nulliparas

7 hrs in multiparas

Question 13

what is 2nd stage of labor

Answer 13

from full dilation to delivery

woman actively PUSHING

50 min in nulliparas

20 min in multiparas

Question 14

what is 3rd stage of labor

Answer 14

expulsion of placenta, after baby’s delivered

~15 minutes

Question 15

what is this called, when does it occur?

Answer 15

2nd stage of labor

crowning / delivering of baby’s head

Question 16

what is turtle sign

Answer 16

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

Question 17

complications during 1st stage of labor?

Answer 17

1) arrest of dilation
2) arrest of descent

Question 18

complications of labor/delivery during 2nd stage?

Answer 18

shoulder dystocia - turtle sign

Question 19

complications of labor/delivery during 3rd stage?

Answer 19

1) retained placenta (placenta doesn’t come out)
2) placenta accreta/increta/percreta
3) uterine inversion
4) post-partum hemorrhage > lacerations, uterine atony

Question 20

what is placenta acreta

Answer 20

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

Question 21

what is uterine atony

Answer 21

uterus not well-developed

Question 22

what’s notable about fetal heart rate

Answer 22

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

Question 23

what is pitocin

Answer 23

synthetic hormone, inducs labor contractions

Question 24

what is episiotomy?

Answer 24

cut perineum between vagina & rectum

helps baby come through w/o mother tearing