LEC51: Labor & Delivery Flashcards

1
Q

defn of childbirth?

A

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

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2
Q

defn of labor

A

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

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3
Q

what triggers labor?

A

not totally known

do know interaction btwn fetus, mom matters

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

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4
Q

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

A

uterus is very muscular structure

has to contract and thus expel baby and membranes

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5
Q

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

A

non-pregnant: uterus in anteverted position

~20 weeks: uterus at level of umbilicus

most pregnant: uterus expands, compresses stomach/intestines

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6
Q

relationship between uterus position/weeks of pregnancy?

A

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

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7
Q

why do many pregnant women have heartburn?

A

when uterus compresses stomach, can cause reflux

acid in stomach can go to esophagus

woman eperiences heartburn

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8
Q

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

A

myth

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9
Q

oxytocin function/genesis

A

hormone that induces labor

released by neurohypophysis of pituitary gland

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10
Q

estrogens function in labor

A

increase myometrial contractile activity

stimulate release of oxytocin & prostaglandins

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11
Q

how many stages of labor

A

3

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12
Q

what is 1st stage of labor

A

onset of labor to full dilation

12 hrs in nulliparas

7 hrs in multiparas

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13
Q

what is 2nd stage of labor

A

from full dilation to delivery

woman actively PUSHING

50 min in nulliparas

20 min in multiparas

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14
Q

what is 3rd stage of labor

A

expulsion of placenta, after baby’s delivered

~15 minutes

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15
Q

what is this called, when does it occur?

A

2nd stage of labor

crowning / delivering of baby’s head

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16
Q

what is turtle sign

A

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

17
Q

complications during 1st stage of labor?

A

1) arrest of dilation
2) arrest of descent

18
Q

complications of labor/delivery during 2nd stage?

A

shoulder dystocia - turtle sign

19
Q

complications of labor/delivery during 3rd stage?

A

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

20
Q

what is placenta acreta

A

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

21
Q

what is uterine atony

A

uterus not well-developed

22
Q

what’s notable about fetal heart rate

A

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

23
Q

what is pitocin

A

synthetic hormone, inducs labor contractions

24
Q

what is episiotomy?

A

cut perineum between vagina & rectum

helps baby come through w/o mother tearing