Normal labor and delivery

Question 1

What is labor

Answer 1

uterine activity resulting in progressive dilation and effacement of the cervix

Question 2

What is effacement

Answer 2

Thinning or shortening of the length of the cervix

normal= 2.5cm +

Question 3

What is dilation

Answer 3

diameter of the cervical os in cm

complete is 10cm (100% effacement)

Question 4

What is the presenting part

Answer 4

part of the baby coming through first in the birth canal

-vertex, breech, face, transverse, compound

Question 5

What is station

Answer 5

degree of descent of the presenting part in the birth canal in relation to ischial spine 
the more (-), the further up in the uterus 
the more (+), the closer to the vaginal canal

Question 6

What are the 3 P’s

Answer 6

Power: uterine contractions
Passenger: size, position, lie, attitude, and presentation of fetus
Pelvis/Passage: bony and soft tissue structures of moms pelvis

Question 7

What is the First Stage of labor

Answer 7

Onset of labor to full dilation&effacement

Question 8

What happens in the latent phase of the first stage of labor

Answer 8

first regular contractions to 3-4cm dilation

dilation is slow, <0.5 cm x hr

Question 9

What happens during the active phase of the first stage of labor

Answer 9

3-4 cm to complete dilation (10 cm)

dilation increases to 1cm x hr

Question 10

What happens in the second stage of labor

Answer 10

Complete dilation to delivery

where “PUSH” happens

Question 11

What happens in the third stage of labor

Answer 11

Delivery of infant to placental delivery

usually <30 minutes from infant delivery

Question 12

What are the cardinal movements of labor

Answer 12

Baby changes position to get ready for birth

engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

Question 13

What is acceleration

Answer 13

increase of 15 bpm above baseline, lasting 15 seconds

this increase in HR is a sign baby is doing well

Question 14

What is deceleration

Answer 14

sign baby may be in trouble. HR decreases w/ contractions
Variable: 2/2 cord compression
Late: 2/2 fetal hypoxia, placenta insufficiency, maternal hypotension/hypoxia

Question 15

Explain hypocontractile uterine activity and how do you treat

Answer 15

<3 contractions in 10 minutes, or contraction lasting <50 seconds
<200-250 MVU on IU pressure cath
-Tx: Augment with Pitocin

Question 16

What abnormalities can occur in the “passenger”

Answer 16

Macrosomia 
Lie 
Presentation 
Position 
Attitude 
-if you can manage baby, you can still deliver vaginally. If it's not looking good, opt for C section

Question 17

What is Cephalopelvic disproportion

Answer 17

a non-gynecoid pelvis (narrow, looks like a male pelvis)
may be 2/2 previous injury or illness causing a contracted pelvis
-Need C-section