Normal Labor/Delivery Flashcards
What defines Labor?
Uterine contractions + Cervical Change!
What are Braxton-Hicks contractions?
Irregular uterine contractions WITHOUT cervical change
What are the 2 parts of the 1st stage of labor?
Latent
Active
Latent 1st stage of labor
Onset of labor to 6 cm dilated
– longest portion of labor
Active 1st stage of labor
6 cm dilated to 10 cm dilated
What is the average speed of dilation during the Active 1st stage of labor for nulliparous and multiparous women?
Nulliparous = 1.2cm/hr
Multiparous = 1.5cm/hr
2nd stage of labor
Complete cervical dilation to delivery of baby
3rd stage of labor
Delivery of baby to delivery of placenta
What is the fetal Station?
Position of the fetal head in relation to an imaginary line drawn through the ischial spines
What does (-) station mean?
Fetal head is superior to the imaginary line between the ischial spines
What does (+) station mean?
Fetal head is inferior to the imaginary line between the ischial spines
What are 2 ways to measure fetal HR and what is the normal range?
- Electrode attached to fetal scalp
- External US
= 110 - 160 is normal
With Low-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?
1st = q30 minutes
2nd = q15 minuts
With Low-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?
1st = q30 minutes
2nd = q15 minutes
With High-Risk pregnancies, how often should the FHR be monitored during the 1st and 2nd stages of labor?
1st = q15 minutes
2nd = q5 minutes
What is Variability and what is normal Variability?
Fluctuations in the baseline FHR
– Normal = 6-25 bpm
What defines Minimal Variability? What are some things that can cause this? (4)
< 6 bpm fluctuations in baseline FHR
= Fetal acidemia, hypoxia, opioids, fetal sleep
What defines Marked Variabiliity?
> 25 bpm fluctuations ini baseline FHR
If Variability is sinusoidal in shape, what can that indicate?
Fetal anemia
- Maternal Meperidine use
What is an Acceleration?
FHR increases by more than 15 bpm for more than 15 seconds
– NORMAL and reassuring of fetal status
What is a Deceleration?
FHR decreases by more than 15 bpm for more than 15 seconds
What are the 3 types of Decelerations?
Variable
Early
Late
What does a Variable Deceleration look like?
ABRUPT onset to nadir in < 30 seconds occurring anywhere in relation to the contraction
What does a Variable Deceleration look like?
ABRUPT onset to nadir in < 30 seconds occurring anywhere in relation to the contraction
What does an Early Deceleration look like?
GRADUAL onset with return to baseline that mirrors the contractioin
What does an Early Deceleration look like?
GRADUAL onset with return to baseline that mirrors the contraction
What does a Late Deceleration look like?
GRADUAL onset with the onset, nadir and recovery all being AFTER the end of the contraction
What does a Late Deceleration look like?
GRADUAL onset with the onset, nadir and recovery all being AFTER the end of the contraction
What is the pneumonic to remember common causes of the types of Decelerations?
VEaL CHoP
VEaL CHoP
Variable –> Cord compression
Early –> Head compression
Late –> Placental insufficiency
Common cause of Variable, Early and Late Decelerations?
VEaL CHoP
Variable –> Cord compression
Early –> Head compression
Late –> Placental insufficiency
What is a normal result when measuring fetal movement over a span of 2 hours?
More than 10 movements felt
2 possible results of a Nonstress test?
Reactive
Non-reactive
Reactive Nonstress test
> 2 FHR accelerations in a 20 minute period
What is a normal result of a Nonstress test?
Reactive
= > 2 FHR accelerations in a 20 minute period
If the Nonstress test is Non-reactive, then what?
Further testing should be done
< 2 FHR accelerations in a 20 minute period
What is a Contraction Stress test?
Measurement of FHR with INDUCED uterine contractions
(+) Contraction Stress test? What should you do?
Late Decelerations following most the contractions
= Deliver!
(-) Contraction Stress test?
NO late decelerations following most the contractions
– this is reassuring
What is the pneumonic for what the Biophysical Profile measures?
Test the Baby MAN
Test the Baby MAN for Biophysical Profile
Tone
Breathing
Movement
Amniotic Fluid index
Nonstress test result
When should you use an Umbilical A. Doppler Velocimetry?
Only when IUGR is suspected
What may be seen on Umbilical A. Doppler Velocimetry if IUGR is present?
Reduction/Reversal of umbilical A. diastolic flow
What results do you want for the Nonstress test and Contraction Stress test?
Nonstress test = Reactive
Contraction Stress test = (-)
Biophysical Profile measures? What is a worrisome result?
0-4 = Worrisome
Tone
Breathing
Movement
Amniotic Fluid index
Nonstress test
