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OB > OB Chapter 16: Labor and Birth Process > Flashcards

OB Chapter 16: Labor and Birth Process Flashcards

1
Q

The Intrapartum period begins with __________ and ends with _______________

A

Regular Uterine Contractions; the delivery of the placenta

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2
Q

Process is called _________

A

labor

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3
Q

______________ is conclusion of pregnancy to start of extrauterine life for newborn.

A

Childbirth

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4
Q

Maternal Factors that trigger Labor:

  1. ________ which causes release of prostaglandins which brings on ________
  2. Pressure on the cervix which stimulates the release of __________ by the maternal___________
  3. _______ increases, bringing on uterine response
  4. ________ decreases and helps relax smooth muscles
  5. _______ and ________ work together to to inhibit calcium binding and in muscle cells to increase intracellular Ca levels which activate uterine contractions
A
  1. Uterine muscle stretching; uterine contractions
  2. Oxytocin; posterior pituitary gland
  3. estrogen
  4. progesterone
  5. oxytocin; Progesterone
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5
Q

When _______ levels are inhibited it causes uterine contractions that serve the purpose of dilating and effacing the cervix

A

Calcium levels

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6
Q

Fetal Factors that Contribute to Labor Onset:

  1. ________ and deterioration triggers the initiation of contractions
  2. ____________ increases and decreases placental _______ and increases the release of _______
  3. Fetal membranes produce ________ which stimulate uterine contractions
A
  1. Placental aging
  2. Fetal cortisol concentration; progesterone; prostaglandins
  3. prostaglandins
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7
Q

_________ is the descent of the fetus into the bony pelvis about two weeks before the onset of labor.

A

Lightening

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8
Q

_______ do not usually experience lightening

A

multigravidas

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9
Q

__________ are irregular, false labor contractions

A

Braxton Hicks

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10
Q

The purpose of Braxton Hicks:

A

increase oxygenation of the uterine muscle and get the uterus ready for labor

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11
Q

_______ also known as nesting, refers to the need to put everything in order

A

Maternal energy surge

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12
Q

Cervical changes that suggest impending labor include:
1.
2.
3.

A
  1. Ripening (softening)
  2. dilating
  3. Bloody show/ loss of mucus plug
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13
Q

GI changes that suggest impending labor include:
1.
2.
3.

A
  1. Diarrhea
  2. Indigestion
  3. Nausea
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14
Q

Lower backache leading up to delivery is caused by ______ and ______

A

hormone called Relaxin; the fetus being lower

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15
Q

5 P’s of factors affecting labor:

A
  1. Powers (physiological forces)
  2. Passageway (maternal pelvis)
  3. Passenger (fetus and placenta)
  4. Psyche (woman’s response to labor)
  5. position (mother and baby)
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16
Q

What is included in “powers”

A

physiological forces of labor including uterine contractions and maternal pushing efforts

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17
Q

What is meant by “passageway”

A

maternal pelvis (gynecoid), soft tissues (vaginal rugae), and pelvic station

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18
Q

What is meant by the “passenger”

A

Everything about the fetus and the placenta: how many fetuses, size, gestational age, and position

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19
Q

what is meant by “psyche”

A

the woman’s psychological responses to labor, preparation, sedation, and anesthesia

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20
Q

what is meant by “position”

A

maternal labor positions used to promote labor (upright, walking, ball-bouncing etc)

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21
Q

Uterine contractions are described by:
1.
2.
3.

A
  1. Frequency (in minutes)
  2. duration (in seconds)
  3. intensity (mild, moderate, strong)
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22
Q

How is the duration of uterine contractions measured

A

beginning to end of a single contraction

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23
Q

how is the frequency of contractions measured

A

beginning of one contraction to the beginning of the next contraction

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24
Q

uterine relaxation between contractions is important because:

A

it allows fetal oxygenation by allowing blood flow from the uterus to the placenta to be restored

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25
Q

Measuring the intensity of the contractions is done by palpating the fundus during_______

A

acme (peak of the contraction)

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26
Q

what will a mild, moderate, and strong intensity contraction feel like when palpating the fundus

A

mild: tip of your nose
moderate: chin
strong: forehead

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27
Q

external contraction monitoring uses _______which is a pressure sensitive device that is applied to the uterine fundus

A

tocodynamometer

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28
Q

external contraction monitoring gives information about _____ and ______ but might not give accurate information about _______

A

frequency; duration; intensity

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29
Q

intrauterine pressure catheter is inserted when and where?

A

after the membranes have ruptured the IUCP is inserted through the cervix

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30
Q

how is IUCP measured ? (units)

A

mmHg

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31
Q

___________ is opening of the cervical Os and is expressed in centimeters (0-10)

A

dilation

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32
Q

________ is the shortening and thinning of the cervix

A

effacement

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33
Q

the amount of cervical effacement is usually measured in _________ related to ________

A

percentage; the length of the cervical canal as compared with a non-effaced cervix.

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34
Q

a cervix that has thinned to 3/4 of the normal length of a cervix would be ________ % effaced

A

25%

35
Q

the first stage of labor begins with ______ and concludes when______

A

onset of true labor; cervical effacement and dilation are complete

36
Q

______ usually efface before they dilate

A

primiparas/ nulliparas

37
Q

_______ usually efface and dilate at the same time

A

multiparas

38
Q

three phases of stage 1 of labor:
1.
2.
3.

A
  1. early: 0-3 cm
  2. middle: 4-7 cm
  3. transition: 8-10 cm
39
Q

normal female pelvis that is best suited for childbirth is:

A

Gynecoid

40
Q

_____ pelvis resembles a typical male pelvis and has a triangular or heart shaped inlet

A

android

41
Q

_______ refers to the level of the presenting part in relation to the maternal ischial spine

A

Station

42
Q

ischial spine = station:

A

0

43
Q

when the presenting part lies above the ischial spine it is:

A

at a minus station

44
Q

a station of -5 means:

A

the presenting part is at the pelvic inlet

45
Q

a positive station indicates:

A

the presenting part has descended past the ischial spines

46
Q

a station of +4 means:

A

the presenting part is at the pelvic outlet

47
Q

soft tissue of pelvic floor allows for_________

A

fetus anterior rotation

48
Q

how to strengthen Rugae

A

Kegals

49
Q

_________ is normal fetal presentation

A

cephalic

50
Q

a cephalic presentation means:

A

the fetal head will be the first part to come into contact with the maternal cervix

51
Q

four types of cephalic presentation:

A
  1. vertex
  2. military
  3. brow
  4. face
52
Q

in this cephalic presentation the fetal head is fully flexed (chin is tucked down to chest). It is most frequent and optimal position

A

vertex

53
Q

in this cephalic presentation the fetal head presents in a neutral position (not flexed or extended). top of the head will be the presenting part

A

military

54
Q

in this cephalic presentation the fetal head is partly extended- unstable and converts to flexed or fully extended position eventually

A

brow

55
Q

in this cephalic presentation the fetal head is fully extended (back of head is near extended toward fetal spine)

A

face- babies face will be the presenting part

56
Q 
Components of vertex presentation:
1. 
2.
3.
4.
A
  1. head enters birth canal first
  2. fetal face is backward (toward mom’s spine)
  3. arms crossed
  4. chin and neck bent forward toward chest
57
Q

______ is the fetal head’s ability to change shape in order to come through the birth canal

A

molding

58
Q

__________ refers to fetal position and the relationship of fetal parts to one another

A

fetal attitude (posture)

59
Q

_________ refers to the spine of fetus in relation to the spine of the mother

A

fetal lie

60
Q

__________ refers to the part of the fetus that enters the pelvic inlet

A

fetal presentation

61
Q

________ is the largest part of the fetus to come through birth canal

A

fetal head

62
Q

the fetal skull is made up of:

A

2 parietal bones; 2 temporal bones; 1 occipital bone

63
Q

_______ are membranous spaces between bones that are used to determine positioning of the head

A

sutures

64
Q

________ are intersections of the sutures

A

fontanelles

65
Q

normal biparietal diameter of fetus (BDP)

A

9.25-9.5 cm

66
Q

a ______ presentation occurs when the fetal buttocks enters the maternal pelvis first

A

breech

67
Q

with ___________ there is an increased risk for umbilical cord prolapse

A

breech presentation

68
Q

the three types of breech presentation include:

A
  1. frank
  2. complete (full)
  3. footling
69
Q

______ is the most common type of breech presentation and is when the fetal legs are completely extended upward toward the fetal shoulders

A

Frank

70
Q

_______ is a breech position when the fetal legs are flexed (crisscrossed)

A

complete

71
Q

________ is a breech position when the fetal legs are extended and one or both feet are the presenting parts

A

footling

72
Q

four landmarks on the fetus that are used to describe position

A
  1. occiput
  2. mantum (chin)
  3. sacrum
  4. acromion process
73
Q

for a vertex presentation we use _ to describe fetal position

A

O- occiput

74
Q

for a face presentation we use _ to describe fetal position

A

M- mantum (chin)

75
Q

for a breech presentation we use _ to describe fetal position

A

S- sacrum

76
Q

for a shoulder presentation (transverse) we use _ to describe fetal position

A

A- acromion position of the shoulder

77
Q

what does “R/L” refer to when describing fetal position

A

right or left side of the maternal pelvis

78
Q

what does “A/P/T” stand for when describing fetal position

A

whether the presenting part is Anterior, Posterior, or Transverse in relation to the maternal pelvis

79
Q

side effects of Lightening (5 major s/e)

A
  1. leg cramps
  2. increased pelvic pressure
  3. increased urinary frequency
  4. increased venous stasis (peripheral edema)
  5. increased vaginal secretions
80
Q

amniotic fluid should be ______ and _____ when amniotic sac ruptures

A

clear; odorless

81
Q

yellow-green tinged amniotic fluid might indicate______ or ________

A

infection; fetal passing of meconium

82
Q

three different tests used to confirm presence of amniotic fluid:

A
  1. Nitrazine tape test
  2. AmniSure
  3. fern
83
Q

weight loss leading up to labor

A

there is a reduction of fluid retention toward the end of pregnancy because of changes in levels of estrogen and progesterone so mommy can lose up to 3 pounds

84
Q

true labor versus false labor

A

true labor contractions lead to progressive dilation and effacement of the cervix

true labor contractions occur with regularity and increase in frequency, duration, and intensity

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