OB quiz 2 Flashcards
Passenger (Fetus and placenta)
a. Come out at the same time, will determine how fast or slow the birthing will happen
b. First shoulder to come out is the anterior shoulder, then posterior shoulder. Getting the head out and shoulders is slow, then baby slips right out.
- Passageway (birth canal)
a. Pelvis through cervix into the vagina and out.
- Powers (contractions)
a. Involuntary and voluntary powers combine to expel the fetus and the placenta from the uterus. Involuntary uterine contractions called the primary powers, signal the beginning of labor.
- Position of mother
a. Squatting is the optimal, and more natural position.
b. Most births occur laying down in the US.
- Psychologic response
a. How is the mother handling labor?
b. Breathing/relaxation pushing when the time comes.
- Passenger- size of fetal head
a. Fetal head is largest part that has to get through the birth canal.
b. Biparietal diameter- diameter of babies head. (9.25 cm)
- Passenger- fetal presentation
a. Presentation refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor.
b. Breach presentation, head first, shoulder presentation.
- Passenger- fetal lie
a. Vertex mans head is down, butt down is a breach delivery. Breach deliveries can be dangerous.
b. Lie is in relation of the long axis of the fetus to spine of the mother.
- Passenger- fetal position
a. Put 2 fingers in, how much mother is dilated, baby is head first/breach, which position the baby is laying. Can tell this by feeling the fontanels.
b. ROA or LOA are the two best positions to be in.
c. Transverse is very hard to birth, as well as posterior.
- What shape is the posterior fontanel
a. Triangular
- Which fetal position will result in the mother having a lot of back pain
a. Posterior position, because the head is pressing on the sacrum.
- Lower uterine segment
a. Part of the uterus that has to work really hard, very muscular.
b. Fondus- top of uterus, where contractions start and spread to lower cervix.
- Cervix
a. Has to open to 10cm, at 10cm you only feel babies head, not the cervix.
b. Finger tip= 1T
c. 2 fingers- 2 cm
d. Dilates on average 1 cm/hr.
- Components of the passageway
a. Bony pelvis, lower uterine segment, cervix, pelvic floor muscles, vagina, introitus-peronieum
- Cervix thinning
a. Cervix thinning is measured in percentages. 100% is the thinnest.
b. Effacement is the thinning out of the cervix.
c. Mucus plug coming out is not eminent of delivery, could still be 2 weeks.
- Primary powers
a. Ferguson reflex- maternal urge to bear down.
- Valsalva maneuver
a. Is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one’s mouth, pinching one’s nose shut while pressing out as if blowing up a balloon.
b. This is discouraged during pregnancy.
- Chorioamnionitis-
a. Inflammation of the fetal membranes (amnion and chorion) due to a bacterial infection. Results from bacteria ascending into the uterus from the vagina and is most often associated with prolonged labor. Bag of water ruptured prematurely, lots of bacteria.
- Position of laboring woman
a. Frequent changes in position relieves fatigue, increases comfort, & improves circulation.
b. Best position is squatting.
c. If you have an epidural, you cannot squat.
- Labor
a. Process of moving fetus, placenta, and membranes out of uterus and through birth canal.
- You have to be cautious about when you give an epidural because…
a. If you wait too late for an epidural, the baby will not be breathing well when she is delivered, will be a “limp rag doll” because it just got a big dose of narcotics.
b. If you give too early, could stop the labor.
- Signs preceding labor
a. Lightening or dropping
b. Blood show
- What stage of labor is the most variable in patients
a. First stage, onset to full dilation
- First stage of labor
a. Onset to full dilation
- Second stage of labor
a. Full dilation to birth, hopefully within the next hour
