Normal L&D and Complications Flashcards
This term means relationship of long axis of fetus to long axis of birthing human?
Lie
This term describes the fetal structure closest to the pelvic opening?
Presentation
This term describes the fetal position in the birth canal?
Station
What is the stretching and thinning of the cervix?
Effacement
What is the opening of the cervix?
Dilation
This term is defined as regular contractions causing cervical dilation and effacement?
true labor
This term is defined as real contractions that don’t cause cervical change?
false labor
When is stage one of labor?
- ## from onset of true labor to complete cervical dilation
What is stage 2 of labor and what happens to mama and fetus during this stage?
- From complete cervical dilation to birth of fetus
- Mama will have urge to push
- Fetus will go through 6 cardinal movements
Placenta normally separates at what time period after birth?
2-10 minutes
a fresh show of blood, the umbilical cord lengthening, the fundus rising up, and the uterus becoming firm are all signs that what is happening?
Placenta is leaving the building…. uterus, leaving the uterus
What happens in stage 3 of labor?
Fetus and placenta are birthed
In what stage of labor are uterine massage, and vaginal repair completed?
third stage
What is stage four of labor?
placental birth to the stabilization of mama (about 6H)
The first 4H immediately following birth is a high risk period for what?
post partum hemorrhage
What are the 6 cardinal movements of the fetus that happen in stage two of labor?
Descent
flexion
internal rotation
extension
external rotation
expulsion
how long should you wait to clamp the umbilical cord once fetus is born?
1-2 minutes
In this cardinal movement the fetus’s chin is pushed to chest so smaller portion of head presents first?
Extension
In this cardinal movement the fetus turns its face to moms coccyx?
internal rotation
this cardinal movement is when the fetus “crowns”?
extension
In this cardinal rotation, the fetal head is birthed and the shoulders align anterior and posterior to the pelvis?
External rotation
In this cardinal movement the fetus should come out anterior shoulder first, then posterior shoulder?
Expulsion
What is 511 in contraction monitoring?
contractions every 5 minutes lasting 1 minute for at least 1H
The strap/monitor placed low on mamas belly monitors what?
Uterine contractions
What tells us the frequency of contractions during labor?
Tocometer
How many contractions is too many?
> 5 in 10 minutes
How do we measure the frequency and force of contractions?
intrauterine catheter (measures pressure)
This term means dysfunctional labor that can happen at any point before or during labor?
dystocia
This type of labor last longer than normal without progression into stages; or has slower than normal changes?
prolonged
This type of labor shows no changes as time passes?
arrested labor
Arrest of dilation in labor is defined as what?
4H of adequate contractions with no cervical change
In arrest of decent, a nulliparous person is pushing longer than ___H with no fetal descent?
3
What are 3 risks of prolonged labor?
- Infection.
- Postpartum hemorrhage.
- Future incontinence.
- Future pelvic organ prolapse.
- Uterine rupture
What is a surgical enlargement of posterior aspect of vagina?
Episiotomy
What are the 5 main indications for preforming an episiotomy?
- patient at high risk of a third- or fourth-degree laceration
- Genital mutilation HX
- Fetal distress
- Need space to use suction or forceps
- avoid shoulder dystocia
What is shoulder dystocia?
When one of the fetal shoulders is stuck behind the mothers pelvic bone and it causes damage to the brachial plexus
Gestation age that’s considered early term (not preterm) ?
37-38.6 weeks
What gestational age is considered full term?
39-40.6
What gestational age is considered late term?
41-41.6
What is the major risk of delivering after 42 weeks?
Still birth due to placental insufficiency
What are the two complications a mom could have if they go past 42 weeks?
Labor dystocia
C-section required
What are some possible fetal complications of carrying past 42 weeks?
- Macrosomia
- meconium
- still birth
- intrauterine infection
At what gestational age should elective birth induction be offered?
39 weeks
This is is done for high risk births and cannot be done before 38 weeks due to higher risk of fetal death <38 weeks?
Labor induction
What are the 2 steps of labor induction?
- Cervical ripening with Cervidil or cytotec 25mg intervaginal
- Administer oxytocin IV
These are complications of what drug use to do what in pregnancy: hyperstimulation or fetal distress; uterine rupture; severe water intoxication; uterine muscle fatigue which can cause uterine atrophy and PPH?
Oxytocin used to induce labor
This system is used to determine the favorability of a vaginal birth using the status of the cervix and the station of the fetal head?
Bishop score
What is a favorable score range for proceeding with a vaginal birth using the Bishop score?
between 9-13
What is the cephalic version and when is it used?
It is manipulation of the fetus via the abdominal wall
Indicated when the fetus is not in a good presentation
The goal of this procedure is to assist in delivery when mom is exhausted, when there is a prolonged second stage, in fetal distress, or in the case of a maternal medical condition. The baby must be in perfect station!
Operative vaginal delivery
What is Operative vaginal delivery?
Use of forceps or suction to help get the fetus out of the vagina and avoid a c-section
