Normal Labor Flashcards
What is the G TPAL classification?
Gravidity Parity -term -preterm -abortions -living children
When is gestation measured from?
The first day of the last menstrual period
What is the definition of Preterm labor? Post Term?
Prior to 36 weeks
Continuing beyond 42 weeks
What are the phases of labor
Phase 0: quiet through inhibitors Phase 1: Cervical Softening Phase 2: Oxytocin receptors inc. uterine irritability. Cervical Ripening. Progest Withdrawl. CRH Phase 3: Labor. Phase 4: Peurperium. Myometrium rigid
What are the inhibitors of labor?
Progesterone
Prostacyclin
Relaxin
What are the Powers, Passenger, and Passage?
Powers: Force gen by uterus:
Passenger: Fetus
What factors are measured in contractions?
Frequency, Duration, Intensity
What factors are measured in the Passenger?
Size
Lie: relat. of fetal spine to maternal spine
Presentation: fetal part that directly overlies the pelvic inlet
Position: Rel between fetus and maternal pelvis (3 initials)
MatFetMat
What is compound presentation?
More than one fetal part presenting
What is Malpresentation?
Any presentation that isn’t cephalic with occiput leading
What Are the factors considered in Passage?
Obstetric Conjugate (smallest part of the pelvic inlet) and Shape of Inlet
What are the different shapes of the female bony pelvis?
Gynecoid- Classic Oval (most common)
Anthropoid- Exaggerated oval
Android- Male- Heart shaped
Platypelloid- Broad, flat
What are the Stages of Labor?
Latent - change in rate of dilation
Active- Most cerv dilation
Descent(2nd stage)- Pushing
What are the complications to regional anesthesia?
Hypotension
Post Dural headache
Fever
Bradycardia
What are the absolute contraindications to Regional anesthetic?
Refracory hyotension Coagulaopathy Thrombocytopenia LMWHep Untreated Bacteremia Skin infection over site of needle ICP caused by mass
What is the regional block used just for the perineum?
Pudendal nerve block
What are the cardinal movements of labor?
Engagement, Descent, Flexion, Int Rot, Extension, Ext Rot, Expulsion
What are the parts of the Initial assessment in labor?
Review Prenatal record Focused History PE Labs: CBC, blood type/Rh, Ab screen, HIV, Hep B, syphilis
What is included in Intrapartum management?
Suportive Care First Stage: FHR q30 min D&AC Second Stage: FHR q15 min Linited oral intake Electronic fetal monitoring
When should cervical dilation be checked?
On admission 1st stage: 1-4 hrs Prior to analgesia When feel urge to push Fetal heart abnormalities (umbilical cord)
What is the Passive and Active management during delivery of the placenta?
Passive: Lengthening of UC Gush of blood Change in shape of fundus Active: Oxytocin Controlled Cord Traction
