OB Exam 3

Question 1

what is labor?

Answer 1

Labor is a natural process that occurs between 38 to 42 weeks’ gestation. The fetus, umbilical cord, placenta, and amniotic membranes are expelled from the uterus through uterine contractions, cervical effacement, and dilation.

Question 2

Influencing factors of the physiology of labor

Answer 2

1. Uterine Muscles Stretch
2. Hormonal changes
3. Placental aging
4. increased sensitivity to oxytocin - causes uterine contractions

Question 3

Uterine Layers - External

Answer 3

covers fundus, extends to ligaments that support uterus

Question 4

Uterine Layers - Internal

Answer 4

contains fibers, that act like sphincters around the opening of the fallopian tubes and cervix.

Question 5

uterine Layers - Middle

Answer 5

A dense network of fibers and blood vessels, contracts after placental delivery to prevent blood loss

Question 6

Musculature changes of pelvic floor

Answer 6

1. Levator Ani and fascia - structures pull the vagina and rectum up and forward during each contraction.
2. Pressure from the fetal head causes pelvic floor muscles to thin from 5cm to 1cm before birth

Question 7

Signs of labor - Bloody Show

Answer 7

Blood-tinged mucus from the cervix, found before or during labor, usually happens 24-48 hours before labor.

Question 8

Signs of Labor - Burst of energy

Answer 8

This is the “nesting instinct”, the mother feels the urge to complete tasks before the baby’s arrival, which usually happens 24-48 hours before labor. Try to conserve energy for labor.

Question 9

Signs of Labor - Spontaneous Rupture of Membranes

Answer 9

‘Water breaking” - gush or trickle. It should be clear and odorless. Yellow/green amniotic fluid may indicate fetal distress, report and proceed to L/D immediately.

Question 10

Signs of Labor - Lightening

Answer 10

After 38 weeks, when the fetus comes in contact with the pelvis. It causes leg cramps, pelvic pressure, and increased edema.

Question 11

Signs of Labor - Braxton Hicks

Answer 11

Irregular, mild contractions, start in the second trimester, and cause false labor, meaning no cervical changes or dilation. Belly feels tight, but it is NOT painful.

Question 12

Signs of Labor - True Labor

Answer 12

Uterine contractions become regular, intensify over time, and radiate from the lower back or pelvis to the abdomen.
Pattern - mild, increases in strength, peaks, and fades away.

Question 13

Signs of Labor - Effacement

Answer 13

The cervix thins, upper uterine muscles shorten, and longitudinal traction of the cervix.
0% - thick, uneffaced cervix
100% - fully thinned/effaced cervix
Effacement occurs more rapidly in the second birth and on.

Question 14

Signs of Labor - Dilation

Answer 14

The gradual opening of the cervix to approx. 10 cm - big enough for baby’s head to fit.
Dilation occurs more rapidly in the second birth and on.