Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's Health 2 > Normal Labor/Delivery > Flashcards

Normal Labor/Delivery Flashcards

1
Q

What is the 1st stage of labor?

A
  • onset of regular contractions to complete dilatation

- latent + active labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define latent labor

A

“Are you having regular contraction and cervical change?”

< 4 cm dilated with irregular or regular uterine contractions (Ucs) → HOME

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define active labor

A

4cm to 10 cm with regular UCs → Admit and Expectant Management

  • Primiparous = 1.2cm cervical dilation/hr
  • Multiparous = 1.5cm cervical dilation/hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define 2nd stage of labor

A

complete dilatation to delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define 3rd stage of labor

A

delivery of infant to delivery of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is placenta accreta?

A

when the placenta attaches too deep in the uterine wall but it does not penetrate the uterine muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 P’s?

A

Power (uterine contractions)

Passenger (fetal position or size)

Pelvis (cephalo-pelvic disproportion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rule of 5-1-1

A

if a patient has contractions 5 minutes apart, lasting for a minute each, for at least one hour, then she is probably in true labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is required from contractions for labor to progress?

A

contractions must be sufficiently strong and frequent enough to effect cervical change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you measure contractions?

A

-internal uterine pressure catheter (IUPC) is required

NOTE: an external tocometer does not accurately measure the strength of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define fetal lie

A

“Lie” refers to the relationship of the cephalocaudal axis (spinal column) of the fetus to that of the mother.

  • Vertex, breech, or transverse
  • Should be known prior to labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define fetal presentation

A

“Presentation” is determined by the fetal lie and the body part that enters the pelvic passage first.

  • Cephalic, breech, or shoulder
  • May be determined with cervical dilation or labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 3 ways can we monitor progress in labor?

A
  • Cervical dilatation
  • Cervical effacement
  • Fetal station
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 labor curves?

A
  1. prolonged latent phase
  2. prolonged active phase
  3. arrested active phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define prolonged latent phase

A
  • described as taking more than 20 hours for a primiparous patient or more than 14 hours for a multiparous patient to reach 4 cm dilation with regular contractions ( active labor)
  • may treat with a therapeutic rest or pitocin or c/s if urgently indicated.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define prolonged active phase

A
  • reflective of a protraction disorder
  • this describes a rate of cervical dilation less than 1.2 cm/hr for multips OR 2cm descent/hr and 1.5 cm/hr for primips OR less than 1 cm descent of the fetal head per hour.
  • may treat with expectant management or c/s if CPD suspected.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define arrested active phase

A
  • defined as 2 hours without cervical change or fetal descent in a patient with clinically adequate contractions.
  • treatment most frequently is c/s for delivery
  • depending upon the clinical scenario, therapeutic rest or pitocin may be reasonable before proceeding with c/s.
18
Q

Cervical dilation

-closed to 10cm

A
  • closed = 0 cm = can’t place a finger inside the os
  • 1 cm = 1 finger
  • 2 cm = 2 fingers laid on top of each other
  • 3 cm = 2 fingers side by side
  • 4 -5 cm = active labor
  • complete = 10 cm
19
Q

Define cervical effacement

A

-the thinning and
shortening of the cervix that occurs as the fetus descends into the pelvis
-described as a “%”

20
Q

How are cervical exams reported?

A

-Dilatation in cm
-Effacement
-Station
-Written in OB “shorthand”:
5/50/-1 = 5 cm dilated; 50% effaced; -1 station

21
Q

Define fetal station

A

describes the relationship of the presenting part of the fetal head to the maternal pelvis—in other words, how far down has the fetus descended in the birth canal

22
Q

What is zero (0) station?

A

represents when head is at the level of the ischial spines

23
Q

When do we use the term “engaged”?

A

when the largest diameter of the fetal head passes through the pelvic inlet

24
Q

Define fetal position

A

-refers to the position of the fetal head in the maternal pelvis as it presents in Stage II of labor

25
Q

What landmarks are used to determine fetal position?

A

fetal fontanelles and sutures

26
Q

Occiput Anterior (OA)

A
  • Fetus is face down
  • Occipital bones present anteriorly
  • The lambdoid suture is major landmark to identifying this position
  • **Preferred position for delivery
27
Q

Occiput Posterior (OP)

A
  • Fetus is face up
  • Occipital bones are posteriorly located
  • Anterior fontanelle is the landmark to identify this position
  • Alternatively, sutures may be palpated as a “3 pronged fork”
  • **Not ideal for vaginal delivery
28
Q

Right Occiput Transverse Position

A
  • Fetal head lies sideways
  • Landmarks are the sagittal suture, lambdoid suture, and anterior fontanelle
  • Orientation based upon position of fetal occiput to maternal side
  • This fetus lies in a Right Occiput Transverse position
  • *Must rotate for delivery: this often happens naturally
29
Q

List the cardinal movements of labor

A
  • Descent
  • Engagement
  • Flexion
  • Internal Rotation
  • Extension
  • External Rotation
  • Expulsion
30
Q

Analgesia and Anesthesia

A
  • None
  • IV Meds – Stadol
  • Local – Pudendal
  • Epidural – Regional anesthesia
31
Q

What are complications of analgesia and anesthesia?

A

Maternal Hypotension!!

32
Q

When is an episiotomy indicated?

A

Indicated in urgent situations to increase the vaginal outlet

  • Shoulder Dystocia
  • Fetal Macrosomia
33
Q

Complications of episiotomy

A
  • Bleeding
  • Hematoma
  • Swelling
  • Infection
  • Leaking of stool or gas
  • Pain during sex
34
Q

List the indications for Cesarean-section

A
  • Previous c-sec
  • Fetal Distress
  • Malpresentation
  • Active Mat HSV
  • Severe Mat Condylomata
  • Fetal Congenital Anomalies
  • Placenta Previa/Abruption
  • Failure to Progress/CPD
  • HIV
35
Q

C-section complications to baby

A

breathing problems

36
Q

C-section complications to mother

A
  • Increased bleeding
  • Reactions to anesthesia
  • Blood clots
  • Wound infection
  • Surgical injury
  • Inflammation and infection of the membrane lining the uterus
  • Increased risks during future pregnancies
37
Q

Maternal indications for forceps/vacuum

A
  • Maternal Exhaustion
  • Prolong 2nd stage
  • Cardiac/Pulm dz
38
Q

Fetal indications for forceps/vacuum

A
  • FTP at low station
  • Failure of fetal head to rotate
  • Fetal distress
  • Control of fetal head in vaginal breech delivery (forceps only)
39
Q

Contraindications to forceps/vacuum

A 
1- Breech
2- Should not be used vacuum for preterm
3- Face presentation 
4- Fetal Coagulopathy
5- Previous scalp sample
40
Q

Forceps/Vacuum Complications

-Maternal

A
  • Vaginal laceration due to entrapment of vaginal mucosa b/t suction cup & fetal head
  • Trauma to the soft tissues: 3rd & 4th degree double the risk compared to vacuum
  • Trauma to urethra & bladder
  • Bleeding from laceration
  • Pain
41
Q

Forceps Complications

-Fetal

A
  • Bruising & laceration of the face
  • Injury to fetal scalp
  • Cephalohematoma
  • Retinal hemorrhage
  • Skull fracture (rare)
  • Facial nerve damage (rare)
42
Q

Vacuum Complications

-Fetal

A
  • Injury to fetal scalp: chignon, abrasion, lacerations, scalp necrosis
  • Cephalohematoma
  • Retinal hemorrhage
  • Birth asphyxia (related to the extraction force & time – vacuum))
  • Neonatal jaundice
  • Subgaleal hematoma: potential bleeding into the space the scalp & skull

Women's Health 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions