Lesson 1 and 2 Flashcards
is a series of continuous, progressive contractions of the uterus which help the cervix to open (dilate) and to thin (efface), allowing the fetus to move through the birth canal.
Labor
movement of the uterus
Contraction
a series of passive, adoptive movements of the fetal head and shoulders smallest diameter to pass through the birth canal
Mechanism of Labor
are the positional movements that the fetus undergoes to accommodate itself to the maternal pelvis
Mechanism of Labor
Mechanism of Labor
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation
Expulsion
the biparietal diameter of the head passes the pelvic inlet
Engagement
the head is fixed in the pelvis
Engagement
occurs when the largest diameter of the fetal head fits into the largest diameter of the maternal pelvis
Engagement
As the fetal head engages, the head moves towards the pelvic brim in either the left or right occipito-transverse position
Engagement
This allows the widest part of the fetal head to fit through the widest part of the pelvic foot
Engagement
the downward movement of the biparietal diameter of the fetal head within the pelvic inlet
Descent
progress of the presenting part through the pelvis
Descent
as Descent occurs, the head bends forward to the chest, making the smallest anteroposterior diameter (the suboccipitobregmatic diameter) present to the birth canal
Flexion
is aided by abdominal muscle contraction during pushing
Flexion
the head enters the pelvis with the fetal anteroposterior head diameter in a diagonal or transverse position
Internal Rotation
fetal skull rotates along the axis from transverse to anteroposterior at pelvic outlet
Internal Rotation
head passes the midpelvis
Internal Rotation
as the occiput (head) is born, the back of the neck stops beneath the pubic arch and acts as a pivot for the rest of the head
Extension
the head extends, and the foremost parts of the head, the face and chin
Extension
almost immediately after the head of the infant is born, the head rotates from the anteroposterior position if assumed to enter
External Rotation
once the shoulders are born, the rest of the baby is born easily and smoothly because of its smaller size
Expulsion
SECOND STAGE OF LABOR – EXPULSION STAGE
Assessment:
signs of imminent delivery
progress descent
maternal/fetal vital signs
maternal pushing effort
vaginal distention
bulging of the perineum
crowning
birth of baby
instrument used to listen to fetal heart tones/heartbeat
doppler
is an incision of the perineum during delivery to enlarge the vaginal opening/outlet
Episiotomy
incision is made in the middle of the perineum and directed toward the rectum
Median or Midline
incision is made laterally to avoid anal sphincter if enlargement is needed
Mediolateral
Signs of Placental Separation
a.) Calkin’s Sign
b.) sudden gush of vaginal blood
c.) lengthening of the umbilical cord
earliest sign of placental separation
Calkin’s Sign
change in shape of uterus from discoid uterine shape to globular
Calkin’s Sign
- placenta separates from the center to the edge
- clean presentation
a.) Schultz (Shiny)
- placenta separates from the edge to the center
- dirty presentation
b.) Duncan (Dirty)
excessive bleeding that occurs after childbirth
Post-partum Hemorrhage
a condition where the placenta partially or completely covers the cervix
Placenta Accreta
decrease labor pain
Epidural Anesthesia
relieve/decrease Episiorraphy pain
Local Anesthesia (lidocaine)
is the surgical procedure of suturing or stitching up an episiotomy or perineal tear after childbirth
Episiorraphy
a technique used in obstetrics to help deliver the placenta during the third stage of labor, which is the period after the baby is born but before the placenta is expelled.
Brandt – Andrews Maneuver
refers to key routine practices in the care of the newborn, particularly at the time of birth and over the first hours of life, whether in the health facility or at lying in birthing center
ESSENTIAL INTRAPARTUM AND NEWBORN CARE
globally accepted evidence-based
protocol to essential newborn care
focusing on the first week of life
ESSENTIAL INTRAPARTUM
AND NEWBORN CARE (EINC)
is a series of time bound, chronologically- ordered, standard procedures that a baby receives at birth.
Essential Newborn Care (ENC) Protocol
Four Time-Bounded Interventions:
- Immediate and thorough drying
- Early skin-to-skin contact
- Properly-timed cord clamping and cutting after
1 to 3 minutes - Non-separation of the newborn from the
mother for early breastfeeding initiation and
rooming-in. (Breastfeeding initiation)
Approved Ophthalmic Agents for Crede’s Prophylaxis
- 1% silver nitrate
- 0.5% erythromycin
- 1% tetracycline
- 2.5% povidone iodine drops
Newborn Examination
- Weighing
- Thorough exam for deformities or
abnormalities - Anthropometric Measurements
- Bowel Patency
- Vital Signs
