LO9 Deliveries Flashcards
- Fertilization
: Occurs in distal third of fallopian tube
- Implantation
Occurs in the uterus
- Placenta
begins to develop after 4th week
- Umbilical cord
o Has 2 arteries 1 vein
Fetal circulation
- Arteries carries the deoxygenated blood back to the placenta
- The veins carry oxygenated blood back to baby
- Ductus venosus
duct that opens when blood comes in
- Blood will leave from left atrium to lungs and return back through ductus arteriosus
- Gestation usually averages
40 weeks from time of fertilization to delivery
24 Weeks
- Sex organs visible
- Covered with lanugo and vernix
- Breathing by inhaling amniotic fluid into lungs
40 Weeks
- Surfactant present
- Baby now about 7.5 lbs
- Week 35-36 baby gain .5lb per week
- Placenta detaches & umbilical cord ceases functioning as child takes first breath of air
- Child’s breathing triggers changes in the structure of the heart and bypass arteries which will force all blood to travel through the lungs
maternal cardiac output increases to approximately
40% reaching its maximum capacity approximately 22 weeks and then declines approximately 20%
- A pregnant woman’s heart
increases slightly due to increased cardiac workload
is displaced upward, forward and to the left with a slight rotation in its long access which causes the apex of the heart to shift laterally
- Enlarged uterus contributes
to slowed venous return, pooling, dependent edema, haemorrhoids and varicose veins
- Lying supine position maternal cardiac output can increase as much is
- Maternal oxygen consumption increases by
25%
20% of 40% above nonpregnant levels entitle volume increases gradually to approximately 40%
- Primigravida
: A woman who is pregnant for the first time
- Multigravida
: A woman who has had two or more pregnancies
- Nullipara
- Primipara- Multipara
- Grand multipara
- Nullipara: A woman who has never delivered
- Primipara: A woman who has given birth only once
- Multipara: A woman who has had two or more deliveries
- Grand multipara: A woman who has had seven deliveries or more
- EDC
estimated date of confinement (40wks/280 days from last menstrual period)
Indications that birth is imminent
- Active labor 5mins apart
- Contractions 1-2mins apart get ready to deliver
- Mom feels like she needs to poop
- Get her top pant so she wont bare down
Prepare for an imminent delivery
- Regular contractions
o 45 to 60 seconds at 1-2 minute intervals - The mother has urge to bear down/sensation of a bowel movement
- There is a large amount of bloody show
- Crowning occurs(!)
- Mother believes delivery is imminent
Dilation – Stage 1
- Start of contractions to full 10cm dilation & thinning of cervix.
- Bloody show
- mucus plug
- Rupture of amniotic sac “…water breaks…”
- Cramp-like pains
- 10 - 20 min apart
- 30-60seclong
- Last days.
Expulsion – Stage 2
- Pass through cervix into vagina
- Contractions
- 2‐3minsapart
- lasting 45 ‐ 90 secs
- Pressure on rectum
- Feeling like pushing
- Bulging of perineum
- Crowning
- Cephalic normal
- Head turn to side
- Can last up to 50 min
- Ends with delivery of the baby
Placenta Delivery - Stage 3
- From delivery of the baby to delivery of the placenta
- Up to 30 min
- Know time
Assisting with Delivery
- Control deliver
- Start to turn baby
- Slip finger along head to check for cord
- Clear airway IF NEEDED
- Gently guide head downward to deliver upper shoulder
- Gently guide head up to deliver lower shoulder
- Maintain newborn at level of vagina to prevent blood drainage from umboilical cord
- Dry warm stimulate baby
- Give baby to mom
- Record time
- Fundus massage
