Normal L And D - Moulton Flashcards
When is a cervical exam inappropriate?
Placenta previa
What is the minimum rate of cervical dilation for primiparas?
Multiparous?
- 2 cm/hr
1. 5 cm/hr
What is the most common general anesthesia induction agent used?
Carries what risk?
Propfol
16x inc risk of maternal mortality
What pelvis resembles an ape, is much larger anteroposterior than transverse diameter, has a narrow pubic arch and creates a long narrow oval shape?
Fetal head position?
Anthropoid
OP
If uncomplicated, External fetal monitoring how often in active phase of 1st stage?
2nd stage?
Complicated 1st stage?
2nd?
Q30 min
Q15 min
Q15 min
Q5 min
What allows you to assess the strength of contractions?
IUPC
Which episiotomy is most commonly performed, has greater risk of extension into 3rd or 4th degree and has less postpartum pain?
Midline
What are Braxton-Hicks contractions?
False labor - irregular contractions w/out cervical change
What bishop score is considered unfavorable?
What score is vaginal delivery good?
< 6
> 8
Supraoccipitomental is what position?
cm?
Brow presentation (longest)
13.5
When is a retained placenta diagnosed?
After 30 min
What is the artificial stimulation of labor which has already begun called?
Augmentation
What is complete dilation?
Effacement refers to what?
10 cm
Thinning of the cervix
Submentogregmatic is what position?
cm?
Face presentation
9.5
What pelvis has the widest transverse diameter w/prominent ischial spines and narrow pubic arch?
Fetal head comes through at what position?
Android
OP - face up
1st degree perineal laceration described how?
2nd?
3rd?
4th?
Superficial, vaginal mucosa or perineal skin
Extends into muscles of perineal body
Extends into or through anal sphincter
Involves the rectal mucosa
Which pelvis types have good prognosis for delivery?
Gynecoid
Anthropoid
Uterine contraction and cervical dilation result in visceral pain in what levels?
Descent of fetal head via what nerve?
T10-T12 through L1
Pudendal n. S2-S4
What stage of labor does bloody show occur?
2nd
What are pitocin complications?
Uterine tachsystole
Antidiuretic effect
Uterine muscle fatigue
Which episiotomy has greater blood loss, is more difficult to repair, has more postpartum pain and increased risk of dyspareunia?
Mediolateral
What maternal position should she be in bed?
How often monitor vitals?
Left lateral recumbent
Q 1-2hrs while in labor
Suboccipitobregmatic is what position?
cm?
Head well flexed
9.5
What stage of labor is complete cervical dilation to delivery of infant?
2nd
What cervical ripening drug is a vaginal insert?
Can be placed vaginally or orally?
PGE2 - Dinoprostone
PGE1 Misoprostol
What are the major causes for postpartum hemorrhage?
Uterine atony - #1
Retained placenta
Unrepaired vaginal laceration
What stage of labor is true labor to complete cervical dilation?
1st - latent and active (dilated 4 cm) phases
What pelvis type is round at the inlet, has a wide transverse diameter and a wide suprapubic arch?
Fetal head comes through what position?
Gynecoid
OA
Labor is defined by regular uterine contractions occurring when and lasting how long?
Every 5 minutes, lasting 30-60 seconds
Order of cardinal movements of labor?
Engagement Descent Flexion IR Extension ER Expulsion
EDF IEEE
Which pelvis has a short AP and wide transverse diamter w/bispinous diameter and a wide suprapubic arch?
Fetal head position?
Platypelloid
Engages transverse diameter
Duration of 1st stage primiparas?
Multiparas?
6-18 hours
2-10 hours
What stage of delivery is delivery of placenta to stabilization of pt?
4th
What labor stage is delivery of infant to delivery of placenta?
3rd
Leopoldo maneuver is used to assess what?
How many maneuvers is it?
Fetal lie
4 - start w/palpating fundus and move down
What AP diameter of pelvic inlet is adequate?
Distance bw ischial tuberosities?
Infrapubic angle?
> 11.5
8.5 cm
> 90 degrees is good
Avg circumference of fetal head?
34.5 cm
Occipitofrontal is what position?
cm?
Head deflexed, OP position
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