Module 04: Components of Labor Flashcards
What are the 6 P’s of Labor or the critical factors affecting the process of labor?
(A) Passenger (fetus)
(B) Passageway (birth canal)
(C) Power (uterine contractions or bearing down)
(D) Psyche (mental status)
(E) Prayer (spiritual needs)
Who is characterized as the passenger?
Fetus
What are the different types of fetopelvic relationships?
(A) Lie
(B) Attitude
(C) Presentation
(D) Position
(E) Station
This is primary related to the fetal skull and is characterized to be the larges part of the newborn’s body.
Fetal Head (size: 1/4 of the newborn’s length)
What are the different types of cranial bones?
(A) Sphenoid
(B) Ethmoid
(C) Temporal
(D) Frontal or sinciput
(E) Occipital or the occiput
(F) Parietal
What are the different types of suture lines?
(A) Coronal
(B) Sagittal
(C) Lambdoidal
This suture line connects two parietal bones.
Sagittal
This suture line connects the parietal and frontal bones.
Coronal
This suture line connects the parietal and occipital bones.
Lambdoidal
This is characterized as the overlapping of the sutures of the skull to permit the passage of the head to the pelvis.
Molding
These are used as landmarks for internal examination during labor to determine the position of the fetus.
Fontanels
How many fontanels are palpable?
Two
This fontanel is characterized to be diamond in shape and is 3 x4 centimeters in size.
Anterior Fontanel or Bregma
This fontanel is characterized to be triangular in shape and is 1 x 1 centimeters in size.
Posterior Fontanel or Lambda
This can maybe be manipulated during delivery to allow passage of one shoulder at a time.
Fetal Shoulder
What are the different important measurements of the fetal head?
Transverse Diameter
(A) Bi-parietal (9.25 cm, largest transverse)
(B) Bi-temporal (8.0 cm)
(C) Bi-mastoid (7.0 cm, shortest transverse)
This is known as the relationship of the spine (long axis) of the fetus to the spine of the mother.
Fetal Lie
In this fetal lie, the fetus’ long axis is parallel with the mother’s long axis. About 99% of cases assume this position.
Longitudinal or vertical (Cephalic: 95%)
In this fetal lie, the fetus is sideways at a 90-degree angle to your spine instead of head up or head down (perpendicular).
Transverse or horizontal (Not normal (malpresentation)
In this fetal lie, the baby’s head is in the mother’s hip. The baby’s body and head are diagonal, not vertical and not horizontal (transverse lie); resembles an x position.
Oblique
This pertains to the relationship of the fetal parts to each other. This also describes the degree of flexion the fetus assumes during labor.
Fetal Attitude
This fetal attitude is normal. This occurs when the chin touches the sternum; vertex to the birth canal.
Complete flexion
This fetal attitude is characterized as the military attitude; occipital frontal or sinciput to birth canal.
Moderate flexion
This fetal attitude is characterized as the brow to the birth canal.
Partial flexion
This fetal attitude is characterized as the face or mentum to the birth canal.
Complete extension
This fetal attitude is the most common and has no contour. Under this, the head is fully flexed on the chest making the parietal bones of the space between the fontanels, the “vertex”, the presenting part.
Vertex or Occiput
Under this fetal attitude, the head is moderately flexed and the sinciput becomes the presenting part.
Sinciput or Military Position
Under this fetal attitude, the back is arched and the neck is extended.
Brow
Under this fetal attitude, the head is extended and the face becomes the presenting part.
Face (not recommended because extreme edema and face distortion may occur)
This pertains to the part of the fetus that presents to or enters the maternal pelvic inlet.
Fetal Presentation
What are the different types of fetal presentation?
(A) Cephalic or vertex (95% of labors)
(B) Breech (34%)
(C) Shoulder or transverse (rare; 1%)
What are the different types of breech presentations?
(A) Complete Breech
(B) Incomplete Breech
(1) Frank breech
(2) Footling breech
(3) Kneeling breech
Under this type of breech presentation, the thighs rest on the abdomen while the legs rest on the thighs.
Complete Breech
Under this type of breech presentation, the thighs rest on the abdomen while the legs extend to the head.
Frank Breech
Under this type of breech presentation, one leg is flexed while the other is extended.
Single footling breech
Under this type of breech presentation, two legs are unflexed and are both extended.
Double footling breech
Under this type of breech presentation, the knees are the presenting part.
Kneeling breech
This pertains to the relationship of the presenting part to the ischial spine denoted in centimeters.
Station
This station pertains that the presenting part is still above the ischial spine and is still floating; hence it needs to rest.
-3 to -5
This station pertains that the fetus is at the level of the ischial spine and is already engaged.
0
This stations means that the fetus is at 3 to 5 cm below the ischial spine.
+3 to +5 (crowning occurs, which signals the second stage of labor)
This is known as the relationship of the fetal presenting part to the specific quadrant of the mother’s pelvis.
Position
What is the most common and most favorable fetal position?
Left Occiput Anterior
What are the most common malpositions and the most painful as well?
(A) LOP
(B) ROP
(Put the mother in squatting position to lesson low back pain)
This is known as the external palpation of the maternal abdomen to determine fetal contour or outline.
Leopold’s Maneuver
What are the different types of grips in Leopold’s Maneuver?
(A) Fundal Grip
(B) Umbilical Grip
(C) Pawlick’s Grip
(D) Pelvic Grip
This assessment of position is used to determine the location of sutures and fontanels to determine the relationship to the maternal pelvis.
Vaginal Examination
This assessment of position is utilized to determine the quadrant where it is best heard.
Auscultation of Fetal Heart Rate
What are the different methods of assessing position?
(A) Leopold’s Maneuver
(B) Vaginal Examination
(C) Rectal Examination
(D) Auscultation of fetal heart rate
What is often used to assess whether the woman will be able to give birth vaginally or not?
Pelvimetry
This type of pelvis is defined as the normal female pelvis and is characterized to be transversely rounded blunt. This is the most favorable for successful labor.
Gynecoid
This type of pelvis is characterized as narrow oval-shaped with an adequate outlet (normal); ape
pelvis.
Anthropoid (A 6.5 baby can get out)
This type of pelvis is characterized to be wedge shaped or angulated. This is often seen in males and is not favorable for labor.
Android (small transverse diameter; no chance for small diameter)
This type of pelvis is characterized to be flat with an oval inlet.
Platypelloid
What types of female pelvis can deliver via normal spontaneous vaginal delivery (NSVD)?
(A) Gynecoid
(B) Anthropoid)
This type of pelvic bone is seen in the lateral or side of the hips.
Ileum
This type of pelvic bone is characterized to be the flaring superior border that forms the prominence of the hips.
Iliac Crest
This division of the pelvis is known as the superior half. This supports the uterus during late months of pregnancy and aids in directing the fetus into the true pelvis for birth.
False Pelvis
This division of pelvis is known as the inferior half. This is formed by the pubes in front, the ilia, the ischia on the sides and the sacrum and the coccyx behind.
True Pelvis
This pelvic bone is characterized as the inferior portion.
Ischium
This pelvic bone is characterized as the area where we sit, this is known as the basis in getting external measurement of pelvis.
Ischial Tuberosities
This pelvic bone is characterized as the anterior portion.
Pubes
This pelvic bone is characterized as the junction between two pubes.
Symphysis Pubis
This pelvic bone is characterized as the posterior portion.
Sacrum
This pelvic bone is characterized as the basis in getting thin sternal measurement of pelvis.
Sacral Prominence
These pubic bones are characterized as the five small bones that are compressed during vaginal delivery.
Coccyx
This is known as the basis in getting the true conjugate.
Diagonal Conjugate
Diagonal conjugate measures between what?
Sacral promontory and the inferior margin of the symphysis pubis (measures 11.5 to 12.5)
This is also known as the conjugate vera.
True Conjugate
The true conjugate measures between what?
The sacral promontory and the superior margin of the symphysis pubis (measures 11.0 cm)
This is defined as diameter that may be measured by closed fist at the level of the tubercosities.
Intertuberous diameter (pelvic outlet)
This is when the transverse diameter + PSD > 15cm (xray pelvimetry) -> outlet adequate.
Thom’s rule
This is known as the forces acting to expel the fetus and the placenta.
Power
What are those that under power?
(A) Involuntary contractions
(B) Voluntary bearing down efforts
(C) Characteristics: wave like
(D) Timing, frequency, duration and intensity
This is known as the psychological stress that exists when the mother is fighting the labor experience.
Psyche and person
What falls under psyche and person?
(A) Cultural interpretation
(B) Preparation
(C) Past experience
(D) Support system
The placenta is formed from what?
(A) Decidua basalis
(B) Chorionic villi
This type of placental separation is characterized from center to edges, presents the fetal surface which is shiny.
Schultz
This type of placental separation is characterized from edges to center, presents the maternal surface which is red beefy and dirty.
Duncan
This pertains to the mother’s spiritual needs. This entails respect the beliefs or religion of the member of the family, especially the mother undergoing the labor and delivery.
Prayer