MCN Normal Labor Flashcards
True Labor signs
painful & regular uterine contractions
bloody show
rupture of membranes
Factors for successful labor ( 4 P’s )
Passenger
Passage
Power
Psyche
determines fetal position
Leopold’s Maneuver
assess which fetal pole occupies fundus
L1
assess fetal orientation
L2
confirm fetal presentation
L3
determine degree of descent
L4
L1 : Which fetal pole occupies fundus?
Fundal Grip
L2 : Where is the fetal back?
Umbilical Grip
L3 : What fetal part lies above pelvic inlet?
Pawlick Grip
L4 : Which side is cephalic prominence on? Is head extended or flexed?
Pelvic Grip
L1: Large, nodular mass
buttocks in fundus
cephalic presentation
L1: hard, round, ballotable
head in fundus
breech presentation
L2: hard, resistant, convex
fetal back
L2: numerous, small, irregular, mobile
fetal small parts
L3: mass not moveable
Engaged fetal head
L3: moveable mass can be displaced upward
Unengaged fetal head
L4: cephalic prominence same side w/ small parts
Head flexed
L4: cephalic prominence same side w/ back
Head extended
relation of fetal long axis to that of the mother
longitudinal, transverse, oblique
Fetal Lie
presenting part
portion of fetal body foremost within the birth canal
felt during IE
cephalic, breech, shoulder, compound
Fetal Presentation
head is the presenting part
cephalic presentation
buttocks / foot is the presenting part
Breech presentation
shoulder / acromion is the presenting part
Shoulder presentation
fetal hand / foot prolapses alongside the presenting part
Compound presentation
posture of the habitus
characteristic posture of fetus in later months of pregnancy
relation of fetal parts to one another
Fetal Attitude
ovoid mass
folded / bent upon itself
back markedly convex
head sharply flexed
chin in close contact to chest
thighs flexed over abdomen
legs bent at the knees
arms crossed over thorax
umbilical cord lies in space between extremities
Fetal Attitude
relationship of defined portion of presenting part to L or R side of
maternal birth canal
Fetal Position
descent of fetus through pelvis occur through 3 important planes
What are the 3 planes
Pelvic Inlet - Superior
Midpelvis
Pelvic Outlet - Inferior
force supplied by fundus with every contraction
maternal pushing efforts/ bearing down
most important force in fetal expulsion
valsalva maneuver
Power
emotional state of the mother during her labor
levels of stress, underlying anxiety, adequate support from partner
ensuring the woman is in a welcoming and supportive environment
Psyche
Fetal head pushes against perineum
fetal scalp appears at vaginal opening
Crowning
surgical incision of perineum made to prevent tearing and to release pressure on the fetal head with birth
Episiotomy
pain during labor is due to
-hypoxia of contracted myometrium
-compression of cervical nerve ganglia and lower uterus
-cervical stretching during dilatation (Ferguson reflex)
-stretching of peritoneum overlying the fundus
Signs of Placental Separation
sudden gush of blood
uterus becomes globular & firmer (Calkins sign)
lengthening of the cord
rise of uterus into the abdomen
