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obstetric - gynecol STEP 2 > normal labor > Flashcards

normal labor Flashcards

1
Q

physiological changes before labor (only the names)

A
  1. lightening
  2. Braxton-Hicks contractions
  3. Bloody show
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2
Q

physiological changes before labor - lightening

A

fetal descent into the pelvic brim

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3
Q

physiological changes before labor - Braxton-Hicks contractions

A

benign contraction that do not result in cervical dilation. They routinely start to increase in frequency towards the end of the pregnancy

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4
Q

physiological changes before labor - Bloody show

A

blood-tinged mucus from vagina that is released with cervical effacement

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5
Q

stage of labor - only names

A
  1. stage 1
  2. latent phase
  3. active phase
  4. stage 2
  5. stage 3
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6
Q

stage of labor - stage 1 (when and duration)

A

onset of labor –> full cervical dilation

primigravid: 6-18 h
multipara: 2-10 h

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7
Q

stage of labor - latent phase (when and duration)

A

onset of labor –> 4 cm dilation

primigravid: 6-7 h
multipara: 4-5 h

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8
Q

stage of labor - active phase (when and duration)

A

4 cm dilation –> full dilation (10 cm)

primigravid: 1 cm per hour
multipara: 1.2 cm per hour

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9
Q

stage of labor - stage 2 (when and duration)

A

full dilation of cervix and mother wants to push –> delivery of neonate

primigravid: 30 mins - 3 h
multipara: 5-30 mins

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10
Q

stage of labor - stage 3 (when and duration)

A

delivery of neonate –> delivery of placenta

30 mins

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11
Q

stage of labor - stage 1 (monitoring)

A

monitor: 1. maternal BP and Pulse
2. electronic fetal monitor (fetal HR and uterine contractions)
3. examine cervix to monitor the progression of labor for
a. cervical dilation
b. effacement
c. station: where the fetus’s fead is located in relationship to pelvis (measured -3 through +3)

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12
Q

stage of labor - stage 2 - the progression of this stage is determined by

A

the rate of fetal head descent

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13
Q

stage of labor - stage 2 - steps

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. external rotation
  7. delivery of anterior shoulder
  8. delivery of posterior shoulder
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14
Q

stage of labor - stage 2 - steps - engagement

A

fetal head enters the pelvis occiput first

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15
Q

stage of labor - stage 2 - steps - descent

A
  • progresses as uterine contraction and maternal pushing over
  • descent continues until the fetus is delivered
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16
Q

stage of labor - stage 2 - steps - flexion

A

fetal head flexion

17
Q

stage of labor - stage 2 - steps - internal rotation

A
  1. when fetus head reaches the ischial spines, the fetus starts to rotate
  2. rotation moves the sagital sutures into forward
18
Q

stage of labor - stage 2 - steps - extension

A

occurs so that the head can pass through vagina (oriented forward and upward)

19
Q

stage of labor - stage 2 - steps - external rotation

A
  • during fetal head delivery, external rotation occurs, giving the shoulders room to descend
  • anterior shoulder goes under the pubic symphisis first
20
Q

stage of labor - stage 2 - steps - delivery of anterior shoulder

A

gentle downward pressure on the fetal head will aid in delivery of anterior shoulder

21
Q

stage of labor - stage 2 - steps - delivery of posterior shoulder

A
  • gentle upward pressure on the fetal head will aid in delivery of posterior shoulder
  • the rest of the fetus will follow
22
Q

stage of labor - stage 3 - definition

A

immediately after delivery, inspect and repair lacerations of the vagina while waiting for placental separation

23
Q

stage of labor - stage 3 - signs of placental separation

A
  1. fresh bleeding from vagina
  2. umbilical cord lengthening
  3. uterine fundus rising
  4. uterus becoming firm
24
Q

induction of labor - medications (only names)

A
  1. prostagladin E2
  2. oxytocin
  3. amniotomy
25
Q

induction of labor - prostagladin E2

A

cervical ripening

NOT IN ASTHMATIC PATIENTS

26
Q

induction of labor - oxytocin

A

exaggerates uterine contraction

27
Q

induction of labor - amniotomy

A
  • puncture of the amniotic sac via amnio hook

- inspect for prolapsed umbilical cord before puncturing

28
Q

false lavor vs latent labor

A
  • false labor, weak, irregular and infrequent contractions, none or mild pain, no cervical change
  • latent labor: regular, increasing frequency, increasing intenisty, with pain and cervical pain
29
Q

oxytocine toxicity

A
  1. tachysystole
  2. low Na2+
  3. hypotension
30
Q

common SE of epidural anesthesia (and mechanism)

A

hypotension (pooling of blood in venous from sympathetic blockage responsible for the vessels)
it can results to fetal hypoxia and acidosis
prevented by IV fluids, repositioning, vassopressors

obstetric - gynecol STEP 2 (22 decks)

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