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Labor > Normal Labor > Flashcards

Normal Labor Flashcards

1
Q

Labor definition

A

Baby and placenta with umbilical cord are expelled out of the uterus

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2
Q

Labor definition

A

Baby and placenta with umbilical cord are expelled out of the uterus

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3
Q

Components of birthing kit

A 
Surgical scissors or a scalpel
Umbilical cord clamps
A small rubber bulb syringe
Towels
4x4 gauze sponges and/or 2x10 gauze sponges
Sterile gloves
Infant blankets
Sanitary napkins
Infant sized bag-mask device
Goggles
A plastic bag
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4
Q

When is a due date?

A

40 weeks from the first day of her last period.

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5
Q

How is due date determined?

A

Based on ultrasound and LMP

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6
Q

When due date is adjusted?

A

When there is >7d difference in 0-13wk

When there is >10 difference in 14-20wk

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7
Q

What is term?

A

Normal timing

37-42

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8
Q

What is preterm?

A
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9
Q

What are contraindication to normal vaginal delivery?

A

Complete placenta previa (baby cannot get out without life-threatening bleed)
Activeherpes simplex lesion
Previous vertical uterine incision or uterine surgery (risk for rupture)
Malpresentation (breech, transverse)

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10
Q

Components of birthing kit

A 
Surgical scissors or a scalpel
Umbilical cord clamps
A small rubber bulb syringe
Towels
4x4 gauze sponges and/or 2x10 gauze sponges
Sterile gloves
Infant blankets
Sanitary napkins
Infant sized bag-mask device
Goggles
A plastic bag
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11
Q

When is a due date?

A

40 weeks from the first day of her last period.

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12
Q

How is due date determined?

A

Based on ultrasound and LMP

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13
Q

When due date is adjusted?

A

When there is >7d difference in 0-13wk

When there is >10 difference in 14-20wk

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14
Q

What is term?

A

Normal timing

37-42

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15
Q

What is preterm?

A
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16
Q

What are contraindication to normal vaginal delivery?

A

Complete placenta previa (baby cannot get out without life-threatening bleed)
Activeherpes simplex lesion
Previous vertical uterine incision or uterine surgery (risk for rupture)
Malpresentation (breech, transverse)

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17
Q

Events during onset of labor

A

Labor is defined as regular, painful, uterine contraction resulting in progressive cervical effacement (thinning) and dilation

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18
Q

What is the name for contractions that do not dilate cervix

A

Braxton-Hicks

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19
Q

What are the signs of labor

A

Onset of contractions
Bloody show
Leaking fluid (rupture of membranes) (ROM)

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20
Q

What is the difference between early vs. active labor

A

will deliver in hours immediate delivery

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21
Q

What are prime events during
1st stage of labor
2nd stage of labor
3rd stage of labor

A

Cervix dilation
Delivery of baby
Delivery of placenta

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22
Q

How much is cervix dilated during 1st stage of labor?

A

10cm

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23
Q

What is important to monitor during 1st stage of labor?

A

Fetal heart beet 110-160 every 5-15min

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24
Q

What needs to be done if fetal heart rate is lower than 90/m for more than 60-90s?

A

1) Woman is on her right side
2) Consider administering Lactated Ringer’s or 0.9% saline w/ oxygen 10L/min by non-rebreather mask
3) Considering to a hands and knees position

25
Q

What starts second stage of labor?

A

Active maternal pushing efforts

26
Q

What should be checked as head is pulled out? What can be done?

A

Nuchal cord

Clamped twice

27
Q

How to proceed with delivery after getting the head out?

A

Gentle downward traction with one globed hand on each side of the fetal head

28
Q

Condition when shoulders are stuck

A

Shoulder dystocia

29
Q

What should be done when baby comes out?

A

Dry it (prevent hypothermia, and stimulate breathing)

30
Q

Delaying clamping 2-3minbenefit and risk

A

+increase iron storage

-jaundice

31
Q

What consists the 3rd stage of labor?

A

Traction on the cord/placenta
Oxytocin 10U IM or 20U/liter NS IV at 250 cc/h

(to decrease bleeding)

32
Q

Purpose of uterine massage

A

Uterus contract limiting bleeding

33
Q

What should be done if there is a laceration of the perineum or vagina

A

Gauze should be applied

34
Q

What questions should be asked when evaluating pregnant woman?

A

Length of Gestation/ Due date (fetal viability/prematurity)
Gravidity and Parity (previous deliveries, live births, premature births)
OBGYN Complications (cesarean or mymectomy)
Pregnancy Complications
Medical Problems
Allergies
Medications
Habits
Prenatal Care

35
Q

How is due date determined?

A

From the first date of the woman’s last menstrual period

36
Q

How gestational age can be estimated w/o LMP?

A

Fundal heights in the 2nd and 3rd trimester or bimanual pelvic exam in 1st trimester

37
Q

How prenatal care affects weight on infants?

A

It decrease number of low birth weight infants

38
Q

What effect on pregnancy does tobacco and other illicit drugs have?

A

Risk of abruption
Preterm labor
Small for gestation age

39
Q

In pregnant woman, what does urge to bear down or having bowel movement may indicate?

A

Imminent delivery

40
Q

Vaginal fluid (examples)

  • normal
  • infection
  • gush
A
  • vaginal discharge can be normal
  • foul smelling
  • rupture of membranes
41
Q

Dark & Spotting vs. Red & Heavy bleeding

A

Dark & Spotting = Benign (e.g. polyp, cervical change)

Heavy bleeding = Uterine rupture, placental abruption

42
Q

Patterns of blood pressure during pregnancy in pregnant woman

A

Decrease in 2nd

Come back in 3rd

43
Q

What is the difference between chronic HTN and preclampsia?

A

20 wks

44
Q

What is the difference between severe and mild preclampsia?

A

160/110

45
Q

How does pulse of pregnant women is different than normal individual?

A

Increases 15-20

46
Q

What is normal temperature for pregnant woman?

A

Can be 1-2 degree higher

It should not be higher than 100.4 F

47
Q

What causes increased respiratory rate and tidal volumes during pregnancy?

A

Progesterone

48
Q

How fundal height can predict age of the fetus?

A

Measure pubic symphysis to top of uterus
Centimeters estimate weeks

Before 20wk hard to palpate
At 20wk at pubic symphysis

49
Q

What is the indication of:
Tender uterus
Tender adnexa

A

Uterine infection, rupture, or abruption

Ectopic pregranancy, infection or ovarian cyst

50
Q

What is the timing and frequency during labor?

A

45-60 seconds ever 3-5 min

51
Q

What is placenta previa?

A

Placenta attachment to the uterus is either covering or close to the cervix

52
Q

What are symptoms of placenta abruption?

A

Back pain and vaginal bleeding

53
Q

What is vasa previa?

A

Blood vessels of the umbilical cord traverse the amniotic membranes prior entering to the cord

54
Q

Presentation of vasa previa

A

No pain to mother
Bleeding bright
Loss of blood to fetus

55
Q

Alignments of fetus with respect to the birth canal?

A

Vertex (head down)
Breeech (buttock or feet down)
Transverse (sideways)

56
Q

Purpose of Leopold’s maneuver

A

Determine orientation of fetus

57
Q

Causes for caridopulmonary arrest associated with pregnancy

A

Amniotic fluid embolism
Preeclampsia
Excess of magnesium sulfate
Postpartum hemorrhage

58
Q

How position in pregnancy can affect blood flow?

A

Uterus can pressure aorta and IVC

59
Q

Modification for CPR with pregnancy

A 
25-30 degree tilt left lateral
Increasing chest wall compression
Use cricoid pressure
Compression higher on strenum
Defibrilaion removal of devices
Heimlich maneuver

Labor (1 decks)

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