Normal Labor And Delivery Flashcards
How do we define labor?
Progressive cervical dilation from uterine contractions that occur every 5 minutes and last 30-60 seconds
Which two pelvis shapes have good prognosis for delivery and which two pelvis shapes have bad prognosis for delivery?
Gynecoid and anthropoid
Android and platypelloid
What is adequate for the diagonal conjugate for delivery?
What is considered adequate of the transverse diameter for delivery?
What is considered adequate for infra pubic angle for delivery?
Greater than 11.5 cm
8.5 cm
Greater than 90 degrees
Where do we check cervical dilation and what is the range?
Internal os, closed to 10cm
What is effacement and how do we report it?
Thinning of the cervix and we report it as a percentage of change from normal thickness.
What is considered station zero of the baby and what is the range of station?
Degree of descent of baby.
Zero station is when head reaches the level of the ischial spines of mom
How many stages of labor are there?
4
What are the two phases of the fist stage of labor and how do we define them?
Latent phase which is onset of labor to about 4 cm of dilation. Slower dilation.
Active phase is 4 cm of dilation moving forward and faster rate of dilation. Admit at this stage.
5 things to monitor for mom during first stage of labor?
Her position IV fluids to stay hydrated Labs Vitals every 1-2 hours Pain meds
How often are we monitoring baby vitals during first and second stage of uncomplicated and complicated pregnancies?
Every 30 minutes first stage and every 15 minutes second stage for uncomplicated
Every 15 and 5 for first and second stage of complicated pregnancies
What should the doc be examining during active phase of stage 1?
Check cervix every 2 hours
Check for dilation, effacement, and station.
What is amniotomy?
Basically, breaking the membranes which can help induce labor. Move things along.
How do we define the second stage of labor?
Baby comes through maternal pelvis and ends with delivery of baby.
What are the 7 cardinal movements of labor?
Engagement, descent, flexion, IR, extension, ER, expulsion
What should mom be doing for easier delivery of baby during delivery?
Lay on back, legs up and spread, and hold breath and bear down.
Two things doc can do when baby’s head comes out?
Bulb suction mouth then nose to clear blood and fluid from airway
Check for nuchal cord
Technique to delivery baby?
Once head is out, gently push down on head to get anterior shoulder out, then pull up on head to get posterior shoulder out. Support body as baby is delivered.
What is an episiotomy and which type is most common?
Cut the vaginal canal to be bigger if you think there is a high chance it will tear.
Midline is best technique.
What is the modified ritgen maneuver for and how is it performed?
To deliver the head.
Use right hand to extend baby and left hand to apply counter pressure on top of head.
What is torn in a first degree, second degree, third degree and fourth degree laceration?
Vaginal mucosa and or perineal skin
Extends into perineal body but not anal sphincter
Extends into or through anal sphincter but not rectal mucosa
Involves rectal mucosa
What is going on during stage 3?
Deliver that placenta
When can we diagnose retained placenta and what do we not do while waiting for delivery of the placenta?
If placenta has not been delivered within 30 minutes
Don’t pull on the cord until classic signs of delivery are seen.
What is a good maneuver to do to encourage the placenta to be delivered?
Apply counter pressure between symphysis and fundus
3 things to complete for management of stage 3?
Repair any lacerations
Monitor uterine bleeding
Check placenta for completeness that everything came out
What is the big deal during stage 4?
Monitoring the patient
Uterine fundal checks and checking vaginal bleeding
What is the goal of cervical ripening?
Stimulate softening, thinning and dilation of cervix
Difference between inducing Labor and augmenting it?
Induction is starting it
Augmenting is stimulating labor that has already started
5 contraindications to induction?
Unstable baby Acute fetal distress Placental previa Previous c section Any contraindications to vaginal delivery
What does the bishop score tell us?
If the cervix is favorable for delivery
