Normal Labor And Delivery Flashcards
Most common fetal lie
Longitudinal
Longitudinal axis of the fetus to that of the mother
Fetal lie
Portion of the fetal body within the birth canal or in closest proximity to it
Fetal presentation
Characteristic fetal posture
Fetal attitude
Relationship of the chosen fetal presenting part to the right or left side of the maternal birth canal
Fetal position
Most common fetal position
Occiput anterior, left
Leopolds maneuver: what part occupies the fundus?
Leopolds maneuver: what
Leopolds maneuver: what side is the fetal back
2nd maneuver
Leopolds maneuver: what part lies over the pelvic inlet
Pawlick’s grip; leopolds 3
Leopolds maneuver: which side is the cephalic prominence
Leopolds IV
Sagittal suture approaches the sacral promontory; ANTERIOR PARIETAL BONE PRESENTS
Naegele’s obliquity
Sagittal suture lies close to the symphysis pubis; POSTERIOR parietal bone will present
Litzman obliquity
Most reliable sign of labor
Cervical dilatatiob
Test to confirm amniotic fluid: collection of fluid in the vagina
Pool test
Test to confirm amniotic fluid: nitrazine test is positive if paper turns what color
Blue
Test to confirm amniotic fluid: crystalization
Fern test
4 parameters of the cervix that are examined
Effacement, dilatation, cervical consistency, cervical position
Bishop scoring criterion include
Dilatation, effacement, station, cervical consistency, cervical position
Bishop score of what indicates probability of vaginal delivery after labor induction is similar to that after spontaneous labor
8
Most important force in the expulsion of the fetus
Maternal intraabdominal pressure
Extreme thinning of the LUS
Pathologic retraction ring/ Ring of Bandl
Descent of fetal head to below pelvic inlet
Engagement
First prerequisite for birth
Descent
Downward movement of fetus through birth canal
Descent
Chin moves towards the thorax due to resistance of maternal structures
Flexion
Rotation of fetal head from transverse to AP
Internal rotation
Movement of chin away from the thorax
Extension
Direct fetal head upward and forward to pelvic outlet
Extension
Restitution; return of the presenting part towards the position it is originally directed
External rotation
Emerging of remainder of fetus
Expulsion
How long is the latent phase of labor?
Nullipara <4hrd
How long is the active phase of labor
<1.5cm/hr (MULTI)
How long is the 2nd stage of labor?
50 mins= NULLI; 20 mins= MULTI
How long is the 3rd stage of labor?
5 mins- Up to 30 mins
Active phase: predictive of outcomr of labor
Acceleration phase
Active phase: measure of overall efficiency of the machine
Phase of maximum slope
Active phase: reflective of the fetopelvic relationship
Deceleration phase
Anesthesia for stage 1 of labor:
natural, IM or IV narcotics (meperidine/morphine), paracervical block
Anesthesia for stage 2 of labor
Epidural block; pudendal block
SE of meperidine/ morphine
Resp depression
SE of paracervical block
Fetal brady
SE of epidural block
Maternal hypotension and spinal headache
Laceration of the anal sphincter
3rd degree
Laceration of fascia ad perineal muscles
2nd degree
Laceration of rectal mucosa
Fourth degree
Sign: uterus becomes globular and firmir
Calkin sign
Detachment from central portion; glistening amnion is presenting at vulva
Schultze
Seperation at the periphery; maternal surface is 1st to appear
Duncan
Discontinue oxytocin if?
Contractions: >5 (10 mins); >7 (15 mins)
Late amniotomy is done when?
5cms cerv dilatation
Used for cervical ripening:2
Misoprostol, PGE2 gel and vaginal insert; foley balloon; laminaria
