Normal Labor and Delivery Flashcards
What is the definition of “Labor”
Progressive cervical dilation from regular uterine contractions that occur at least every 5 minutes and last 30-60 seconds
What is a Braxton Hicks contraction
False Labor –> contractions with no uterine dilation
Def = fetal spine position relative to moms spine
Fetal Lie
Def = part of baby in pelvis
Fetal Presentation
What are the descriptors for Fetal Presentation
Vertex
Breech
Transverse
Compound (vertex + hand)
Def = checked at internal os and ranges form closed to 10cm
Dilation
Def = thinning of the cervix ranging from thick to 100%
Effacement
Def = degree of decent of presenting part of fetus ranging from -5cm to +5cm
Station
Def = labor started by artificial means
Induction
Def = artificial stimulation of labor that has already begun
Augmentation
What components are used for the Bishop score
Dilation Effacement Station Consistency Position
What are the Bishop scores to be familiar with
< 6 is unfavorable
> 8 has good odds of vaginal delivery
What are the most common complications with Pitocin use
Uterine tachysystole
Antidiuretic effect
Uterine muscle fatigue
Uterine contractions and cervical dilation relay pain via which spinal levels
T10-L1
Pressure in the pelvic floor, vagina, and perineum relay pain via which spinal levels
S2-4 (pudendal n.)
Regional anesthesia refers to loss of pain sensation below which spinal level
T10
Which general anesthetic is most commonly used as an induction agent
Propofol
What are the stages of labor
1st = onset of labor - complete cervical dilation 2nd = complete cervical dilation - delivery of baby 3rd = delivery of baby - delivery of placenta 4th = delivery of placenta - stable pt
What is the duration/rate of labor for the 1st stage
Primi –> 6-18 hrs, 1.2cm/hr
Multip –> 2-10 hrs, 1.5cm/hr
What is the duration of the 2nd stage of labor for Primis and Multips
Primi w/out Epi –> 2 hrs
Primi w/ Epi –> 3 hrs
Multip w/out Epi –> 1 hr
Multip w/ Epi –> 2 hrs
What are the 7 cardinal movements of labor
Engagement Descent Flexion Internal Rotation Extension External Rotation Expulsion
What makes the degrees of perineal lacerations differ
1˚ = vaginal mucosa and/or perineal skin 2˚ = into muscles of perineal body 3˚ = through anal sphincter 4˚ = into rectal mucosa
What is the most common cause of postpartum hemorrhage
Uterine atony
