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COMAT - OBGYN > Normal Labor/Delivery > Flashcards

Normal Labor/Delivery Flashcards

1
Q

What defines Labor?

A

Uterine contractions + Cervical Change!

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2
Q

What are Braxton-Hicks contractions?

A

Irregular uterine contractions WITHOUT cervical change

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3
Q

What are the 2 parts of the 1st stage of labor?

A

Latent
Active

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4
Q

Latent 1st stage of labor

A

Onset of labor to 6 cm dilated
– longest portion of labor

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5
Q

Active 1st stage of labor

A

6 cm dilated to 10 cm dilated

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6
Q

What is the average speed of dilation during the Active 1st stage of labor for nulliparous and multiparous women?

A

Nulliparous = 1.2cm/hr
Multiparous = 1.5cm/hr

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7
Q

2nd stage of labor

A

Complete cervical dilation to delivery of baby

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8
Q

3rd stage of labor

A

Delivery of baby to delivery of placenta

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9
Q

What is the fetal Station?

A

Position of the fetal head in relation to an imaginary line drawn through the ischial spines

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10
Q

What does (-) station mean?

A

Fetal head is superior to the imaginary line between the ischial spines

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11
Q

What does (+) station mean?

A

Fetal head is inferior to the imaginary line between the ischial spines

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12
Q

What are 2 ways to measure fetal HR and what is the normal range?

A
  • Electrode attached to fetal scalp
  • External US
    = 110 - 160 is normal
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13
Q

With Low-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?

A

1st = q30 minutes
2nd = q15 minuts

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14
Q

With Low-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?

A

1st = q30 minutes
2nd = q15 minutes

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15
Q

With High-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?

A

1st = q15 minutes
2nd = q5 minutes

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16
Q

What is Variability and what is normal Variability?

A

Fluctuations in the baseline FHR
– Normal = 6-25 bpm

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17
Q

What defines Minimal Variability? What are some things that can cause this? (4)

A

< 6 bpm fluctuations in baseline FHR
= Fetal acidemia, hypoxia, opioids, fetal sleep

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18
Q

What defines Marked Variabiliity?

A

> 25 bpm fluctuations ini baseline FHR

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19
Q

If Variability is sinusoidal in shape, what can that indicate?

A

Fetal anemia
- Maternal Meperidine use

20
Q

What is an Acceleration?

A

FHR increases by more than 15 bpm for more than 15 seconds
– NORMAL and reassuring of fetal status

21
Q

What is a Deceleration?

A

FHR decreases by more than 15 bpm for more than 15 seconds

22
Q

What are the 3 types of Decelerations?

A

Variable
Early
Late

23
Q

What does a Variable Deceleration look like?

A

ABRUPT onset to nadir in < 30 seconds occurring anywhere in relation to the contraction

24
Q

What does a Variable Deceleration look like?

A

ABRUPT onset to nadir in < 30 seconds occurring anywhere in relation to the contraction

25
Q

What does an Early Deceleration look like?

A

GRADUAL onset with return to baseline that mirrors the contractioin

26
Q

What does an Early Deceleration look like?

A

GRADUAL onset with return to baseline that mirrors the contraction

27
Q

What does a Late Deceleration look like?

A

GRADUAL onset with the onset, nadir and recovery all being AFTER the end of the contraction

28
Q

What does a Late Deceleration look like?

A

GRADUAL onset with the onset, nadir and recovery all being AFTER the end of the contraction

29
Q

What is the pneumonic to remember common causes of the types of Decelerations?

A

VEaL CHoP

30
Q

VEaL CHoP

A

Variable –> Cord compression
Early –> Head compression
Late –> Placental insufficiency

31
Q

Common cause of Variable, Early and Late Decelerations?

A

VEaL CHoP
Variable –> Cord compression
Early –> Head compression
Late –> Placental insufficiency

32
Q

What is a normal result when measuring fetal movement over a span of 2 hours?

A

More than 10 movements felt

33
Q

2 possible results of a Nonstress test?

A

Reactive
Non-reactive

34
Q

Reactive Nonstress test

A

> 2 FHR accelerations in a 20 minute period

35
Q

What is a normal result of a Nonstress test?

A

Reactive
= > 2 FHR accelerations in a 20 minute period

36
Q

If the Nonstress test is Non-reactive, then what?

A

Further testing should be done
< 2 FHR accelerations in a 20 minute period

37
Q

What is a Contraction Stress test?

A

Measurement of FHR with INDUCED uterine contractions

38
Q

(+) Contraction Stress test? What should you do?

A

Late Decelerations following most the contractions
= Deliver!

39
Q

(-) Contraction Stress test?

A

NO late decelerations following most the contractions
– this is reassuring

40
Q

What is the pneumonic for what the Biophysical Profile measures?

A

Test the Baby MAN

41
Q

Test the Baby MAN for Biophysical Profile

A

Tone
Breathing
Movement
Amniotic Fluid index
Nonstress test result

42
Q

When should you use an Umbilical A. Doppler Velocimetry?

A

Only when IUGR is suspected

43
Q

What may be seen on Umbilical A. Doppler Velocimetry if IUGR is present?

A

Reduction/Reversal of umbilical A. diastolic flow

44
Q

What results do you want for the Nonstress test and Contraction Stress test?

A

Nonstress test = Reactive
Contraction Stress test = (-)

45
Q

Biophysical Profile measures? What is a worrisome result?

A

0-4 = Worrisome
Tone
Breathing
Movement
Amniotic Fluid index
Nonstress test

COMAT - OBGYN (12 decks)

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