Normal Labor Flashcards
What is cervical effacement?
- the progressive shortening and thinning of the cervix in labor
This hormone upregulates uterotonic receptors.
- Estrogen
A blood gas is performed to check for acidosis if the baby has a Apgar score of how low?
< 5
How can we obtain a qualitative measure of the timing of contractions?
WILL NOT TELL YOU ABOUT STRENGTH OF CONTRACTIONS ONLY TIMING
- External tocometer
What is the classic qualitative definition of adequate labor?
3-5 contractions in 10 minutes
What signs/symptoms must be present to clinically diagnose labor?
- regular painful uterine contractions + progressive cervical effacement and dilatation
What defines the second stage of labor (aka pushing phase)?
- period from full dilatation until delivery of the fetus
How is fetal position determined?
- palpation of the sutures and posterior fontanelle
What are the classifications of the Apgar score?
0-3 = critically low 4-6 = fairly low 7-10 = generally normal
Maximum dilation is defined as?
10 cm
An ideal pelvic shape is what?
round to slightly oval
An episiotomy is consisted with what degree of perineal tear?
- second degree perineal tear
What is considered the best test for an adequate pelvis?
- a trial of labor
What does the evidence say about how fast cord clamping should be done?
- delayed cord clamping leads to better outcomes
What defines the first stage of labor?
- interval between onset of labor and full cervical dilation
Increased synthesis of this hormone in membranes and decidua leads to the transition to labor.
- Prostaglandins
The third stage is considered to be prolonged if it is > ___ minutes.
> 30 minutes
What is the difference between a third-degree and fourth-degree perineal tear?
- third degree = anal sphincter torn
- fourth degree = rectum torn
How can we obtain a quantitative measure of the strength of contractions?
- internal pressure catheter (IPC)
What is the easiest and most common pelvic shape?
- Gynecoid
What does the term “engagement” mean?
- When the fetal head enters into the pelvic inlet
When would you need a pundendal nerve block during pregnancy?
- if a patient needs a forceps delivery but does not have an epidural
What is the most common presentation in vaginal delivery?
- cephalic
What defines the third stage?
- time from delivery of baby to separation and expulsion of the placenta
If you are using an internal pressure catheter (IPC) to quantitatively measure labor, what value is considered “adequate”?
- > 200 montevideo units (MVUs)
Withdrawal of this hormone may be associated with onset of labor.
- Progesterone
Pulsatile release of this hormone causes contractions.
- Oxytocin
What drug can be given to speed up the expulsion of the placenta?
- oxytocin (pitocin)
What is the difference between the latent phase and active phase of the first stage of labor?
- latent phase = Onset of labor to point at which change in the slope of rate of cervical change (usually around 4 cm dilated)
- activate phase = a faster rate of cervical dilation than latent phase
By measuring the fetal size you can estimate this value.
- fetal weight
Fetal station “0” is located at this bony landmark.
- Ischial spine
The easiest vaginal delivery is when the posterior fontanelle of the fetus is facing ______.
- anterior
How many measurements do you need to obtain to estimate the fetal weight using US?
4 measurements
2 of head, 1 of belly, 1 of thigh
