Part 4 - TBN: Baby Mother Flashcards
What composes the first stage of labor?
LATENT
- 1-3 cm cervical dilation
- mild intensity
- 15-30 mins. of contractions
ACTIVE
- 4-7 cm cervical dilation
- moderate intensity
- 3-5 mins. of contractions (30-60 sec in duration)
TRANSITION
- 8-10 cm cervical dilation
- strong intensity
- every 2-3 mins (60-90 sec in duration)
Light stroking of the abdomen which can be done by the mother or their partner
Effleurage
This is the stage where the mother is PUSHING.
- It starts when cervix is fully dilated and effaced; ends after the baby is delivered.
Stage 2 (baby is delivered)
In this stage, the placenta is delivered, 5-30 mins after birth.
Stage 3
Signs of a Placental Delivery
- Lengthening umbilical cord
- Gush of blood
- Uterus changes from oval to globular shape
If the placenta stays in the mother for longer than 30 minutes
Retained Placenta
Uterine tone after placental delivery should be:
- Firm
- Midline
In examining placenta & verifying if it’s intact, it should have:
2 arteries
1 vein
First 1–4 hours after delivery of the placenta
Stage 4
Commonly used during labor to assess fetal oxygenation, fetal heart rate, and fetal hypoxia. It’s a way to continually assess these components.
Electronic Fetal Monitoring
It uses high-frequency sound waves to record the fetal heart rate (FHR).
(Monitoring FHR)
Ultrasound Transducer (External)
Is placed over the fundus and secured by an elastic belt.
It measures uterine activity transabdominally
Monitors: frequency & duration
(Monitoring uterine activity)
Tocotransducer (Tocodynamometer) (External)
Is placed on the fetal presenting part (typically the head)
(Monitoring fetal heart rate)
Spiral Electrode
is placed into the uterine cavity to measure contractions (measured in mmHg)
Monitors: frequency, duration, & intensity
(Monitoring uterine activity)
Intrauterine Pressure Catheter (IUPC)
Types of Electronic Fetal Monitoring
External (Non-invasive)
Internal (Invasive - the membranes must be raptured)
- Indicate fetal well being
- They are typically caused due to fetal movement or contractions
Accelerations
Normal range of fetal heart rate
110-160 bpm
Irregular fluctuations or waves in the fetal heart rate baseline.
Variability
Absent Variability
Amplitude range undetectable (flat line)
- The fetus is not responding well to contractions, birth process, etc.
- Fetal hypoxemia
Minimal Variability
Amplitude Range: < 5 bpm
May be due to:
- The fetus sleeping
- Maternal tachycardia
- Certain medications
- Congenital anomalies
Moderate Variability
Amplitude Range: 6–25 bpm
- Indicates fetal well-being
Marked Variability
Amplitude Range: > 25 bpm
Cause not completely known
May be due to:
- Hypoxia
- Baby stressed while going through the birth canal
Uterine Contractions: Duration
BEGINNING of the contraction to the END of the same contraction.
Interpretation:
- Lasts 45–80 seconds
- Should not exceed 90 seconds
Uterine Contractions: Frequency
Time from the START of one contraction to the BEGINNING of the next.
Interpretation:
- 2–5 contractions every 20 minutes
- Should not be more frequent than every 2 minutes
Uterine Contractions: Intensity
Strength of a contraction at its PEAK
Interpretation:
* 25–50 mmHg
* Should not exceed 80 mmHg
The nose (Mild intensity)
The chin (Moderate intensity)
The forehead (Strong intensity)
Uterine Contractions: Resting Tone
TENSION in the uterine muscle between contractions
Interpretation:
* Average: 10 mmHg
* Should not exceed 20 mmHg
Soft = good; Firm = not resting enough
