Normal Labor & OB Anesthesia Flashcards
when does the transition from latent to active labor occur?
when cervix is 6 cm dilated
Describe the 4 stages of labor
1: Latent = onset of regular uterine contractions; Active: acceleration of cervical dilation(6cm)
2: Cervix 10 cm dilated and baby descends through the birth canal
3: baby delivery begins & ends with placenta delivery
4: 2hr period after the end of stage 3, to monitor mom`
when do you admit a mom to the maternity unit?
when cervical dilation is at least 3 cm or PROM
Management of Prolapsed Umbilical Cord?
place pt in knee-chest position, elevate presenting pts, avoid palpating the cord, give C-Section.
Shoulder Dystocia
Management?
delivery of fetal shoulders is delayed after delivery of the head. Associated w/shoulders in teh AP plane.
tx: suprapubic pressure, internal rotation of the fetal shoulders to the oblique plane
1st degree obstetric lacerations
involves only the vaginal mucosa
2nd degree obstetric lacerations
vagina + muscles of the peritoneal body
3rd degree obstetric lacerations
vagina, perineal body and anal sphincter
4th degree obstetric lacerations
vagina to rectum completely torn
advantages v disadvantages of IV agents for labor
early administration at a low costs. neonatal depression
advantages v disadvantages of paracervical block for labor
bilateral cervical transvaginal block. can be given in active phase of labor. high levels of local anethesia cause fetal bradycardia
advantages v disadvantages of pudendal block for labor
transvaginal block of pudendal nerve taht can be give in stage 2 of labor
advantages v disadvantages of Epidural block for labor
given in stage 1 or 2. block can be patchy. can cause hypotension, CNS bleeding and infection
