Midterm - Mod 4 Flashcards
Four interrelated components called the four “Ps” make up the process of labour and birth. What are the four P’s?
Powers, Passage, Passenger, Psyche
(4 p’s) What is the powers of labour? What are the two powers?
forces that cause the cervix to open and that propel the fetus downward through the birth canal.
- Two powers: uterine contractions (primary power) and the mother’s pushing efforts
what are the effects of contractions on the cervix?
What are the three phases of contractions and what happens?
Efface (thin) and Dilate (open)
•Increment: period of increasing strength
•Peak: period of greatest strength
•Decrement: period of decreasing strength
Intensity is the Approx. strength of contraction and described as mild, moderate, and firm contractions. Describe each
- Mild – fundus is easily indented with the fingertips; fundus of the uterus feels similar to tip of nose
- Moderate – fundus can be indented with the fingertips but with more difficulty; the fundus of the uterus feels similar to chin
- Firm – fundus can not be readily indented with fingertips; fundus feels similar to foreheard
How are contractions measured and what are the numbers we want for frequency, increment peak decrement, and relax period?
Contractions are measured from start of one contraction to the end of that contraction, and then relaxing period.
- No more frequent than 2 min
- Increment peak decrement: no longer than 90 secs
- 60 sec rest break between contractions
the Passage of labour consists of?
The pelvis is divided into what two major parts?
Consists of the mother’s boney pelvis and soft tissues.
•True pelvis (lower part): Directly involved in childbirth is further divided
o Inlet, Midpelvis, Outlet
•False (upper, flaring part)
What are the 4 passengers?
Fetus, placenta, amniotic membranes and amniotic fluid
How is “Lie” described
how the fetus is oriented to the mothers spine
- Most common orientation is the longitudinal lie, in which the fetus is parallel to the mother’s spine
What is the normal fetal attitude?
normally the head is flexed forward and the arms and the legs are flexed; if extension occurs labour may be prolonged
Presentation refers to the fetal part that enters the pelvis first. Cephalic presentation is most common, there are variations that can occur - Vertex, military, brow, face, breech. Describe each
Vertex- fetal head is fully flexed
Military- fetal head is neither flexed nor extended
Brow- fetal head is partly extended
Face- fetal head is fully extended
Breech legs and buttocks are entering pelvis first
Position refers to
how a resting point on the fetal presenting part is oriented within the mother’s pelvis
Psyche in labor refers to
Impact of the woman’s entire being on the birthing process
What are the signs of impending labour
- Braxton Hicks contractions
- Increased vaginal discharge
- Bloody show
- Rupture of the membranes
- Energy spurt
- Weight loss
Reassuring FHR patterns are: Baseline FHR in a normal range of____.
Are accelartions of FHR normal or abnormal?
110 to 160 beats/min, with no periodic changes and a moderate baseline variability
- Accelerations of FHR with fetal movement are normal patterns
Nonreassuring FHR patterns
- Baseline FHR <110 or >160 beats/min
• Decreased or absent variability; little fluctuation in rate
• Late decelerations
• Variable decelerations