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Year 2 OBGYN > Normal labor > Flashcards

Normal labor Flashcards

1
Q

what does G TPAL stand for?

A

gravidity

parity (term, preterm, abortions, living)

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2
Q

definition: labor

A

increase in myometrial activity resulting in effacement and dilation of the uterine cervix

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3
Q

mean duration of human singleton pregnancy

A

280 days (40 wk) from first day of LMP

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4
Q

what is a term pregnancy?

A

period from 36 completed weeks (37.0) to 42.0 weeks

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5
Q

what is a preterm pregnancy?

A

onset of labor prior to 36 completed weeks

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6
Q

what is a postterm pregnancy?

A

continuing beyond 42 weeks

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7
Q

is labor diagnosed clinically or medically?

A

clinically

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8
Q

what are the criteria for labor diagnosis?

A
  • regular painful contractions
  • progressive cervical effacement and dilatation
  • bloody show
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9
Q

phase 0 of labor

A

functional quiescence through inhibitors: progesterone, prostacyclin, relaxin

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10
Q

phase 1 of labor

A

cervical softening: slow progressive structural changes of ECM (collagen alterations)

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11
Q

phase 2 of labor

A

activation - myometrial changes, cervical ripening

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12
Q

phase 3 of labor

A

actual labor - three stages:

  • oxytocin influence
  • PGs, relaxin
  • CRH
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13
Q

oxytocin really has its effect during which phase of labor?

A

phase 3

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14
Q

phase 4 of labor

A
  • puerperium (postpartum interval)
  • myometrium becomes rigid and in state of constant contraction - oxytocin influence
  • uterine involution and cervical repair
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15
Q

what are the three mechanics of labor?

A

powers
passenger
passage

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16
Q

the ‘powers’ mechanics of labor are generated by what?

A

uterus

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17
Q

how is uterine activity described?

A
  • frequency
  • intensity
  • duration
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18
Q

what is the classic definition of adequate uterine activity (how many contractions / minute)?

A

3-5 contractions in 10 minutes

19
Q

definition: lie

A

spatial relationship of fetal spine to maternal spine

20
Q

definition: presentation

A

fetal part that directly overlies the pelvic inlet

21
Q

what does a compound presentation mean?

A

more than one fetal part directly overlies the pelvic inlet

22
Q

what does malpresentation mean?

A

any presentation that is not cephalic with occiput leading

23
Q

what is the best type of lie?

A

vertically oriented (longitudinal)

24
Q

definition: fetal position

how is it described?

A
  • relationship between a fetal denominator and the maternal pelvic
  • described by 3 initials:
  • 1st initial: fetal denominator
  • 2nd and 3rd initial: maternal pelic quadrants toward which the fetal denominator points

(e.g. LOA, LOP)

25
Q

what spot on the fetus marks the orientation?

A

posterior fontanelle (occiput)

26
Q

definition: station

A

relationship of presenting part to maternal ischial spines

27
Q

what does a “0” station mean? negative value?

A

head is at the ischial spines

negative value - above the spines

28
Q

what is the name for the smallest part of the pelvic inlet?

A

true (obstetric) conjugate

29
Q

what is the true (obstetric) conjugate?

A

smallest part of the pelvic inlet

30
Q

what type of pelvic shapes is most conducive to labor?

31
Q

what is the limiting factor for passage in the midcavity?

A

interspinous diameter

32
Q

definition: stage 1 of labor

A

interval between onset of labor and full cervical dilation

33
Q

what are the three subdivisions of stage 1 of labor?

A
  • latent
  • active
  • descent
34
Q

definition: latent phase of stage 1 labor

A
  • between onset of labor and a point at which a change in slope of rate of cervical dilation is noted
  • slow cervical change
35
Q

definition: active phase of stage 1 labor

A
  • greater rate of dilation

- most dilation

36
Q

the most dilation, and greatest rate of dilation, occurs at what point of labor? at what cervical dilation value does it start?

A

active phase of stage 1 labor

4 cm

37
Q

uterine contraction corresponds to what spinal levels?

38
Q

what is the most common complication of regional anesthesia?

A

hypotension

39
Q

what are the durations of labor for nulliparous women? (total, 1st, 2nd, 3rd stages)

A

total: 10-26 hr
first: 10-24 hr
second: 30-120 min
third: 5-30 min

40
Q

how do nulliparous labors compare with multiparous labors in terms of duration of stages?

A

30 minute 3rd stage

41
Q

definition: stage 2 of labor

A

interval between full cervical dilation and delivery of infant

42
Q

definition: stage 3 of labor

how long does this usually take?

A
  • deliver of placenta

- less than 10 m (up to 30 m)

43
Q

what are the changes in position of the fetal head during passage through the birth canal?

A
  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion

Year 2 OBGYN (33 decks)

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