Part 4 - TBN: Baby Mother

Question 1

What composes the first stage of labor?

Answer 1

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)

Question 2

Light stroking of the abdomen which can be done by the mother or their partner

Answer 2

Effleurage

Question 3

This is the stage where the mother is PUSHING.
- It starts when cervix is fully dilated and effaced; ends after the baby is delivered.

Answer 3

Stage 2 (baby is delivered)

Question 4

In this stage, the placenta is delivered, 5-30 mins after birth.

Answer 4

Stage 3

Question 5

Signs of a Placental Delivery

Answer 5

• Lengthening umbilical cord
• Gush of blood
• Uterus changes from oval to globular shape

Question 6

If the placenta stays in the mother for longer than 30 minutes

Answer 6

Retained Placenta

Question 7

Uterine tone after placental delivery should be:

Answer 7

• Firm
• Midline

Question 8

In examining placenta & verifying if it’s intact, it should have:

Answer 8

2 arteries
1 vein

Question 9

First 1–4 hours after delivery of the placenta

Answer 9

Stage 4

Question 10

Commonly used during labor to assess fetal oxygenation, fetal heart rate, and fetal hypoxia. It’s a way to continually assess these components.

Answer 10

Electronic Fetal Monitoring

Question 11

It uses high-frequency sound waves to record the fetal heart rate (FHR).
(Monitoring FHR)

Answer 11

Ultrasound Transducer (External)

Question 12

Is placed over the fundus and secured by an elastic belt.
It measures uterine activity transabdominally
Monitors: frequency & duration
(Monitoring uterine activity)

Answer 12

Tocotransducer (Tocodynamometer) (External)

Question 13

Is placed on the fetal presenting part (typically the head)
(Monitoring fetal heart rate)

Answer 13

Spiral Electrode

Question 14

is placed into the uterine cavity to measure contractions (measured in mmHg)
Monitors: frequency, duration, & intensity
(Monitoring uterine activity)

Answer 14

Intrauterine Pressure Catheter (IUPC)

Question 15

Types of Electronic Fetal Monitoring

Answer 15

External (Non-invasive)
Internal (Invasive - the membranes must be raptured)

Question 16

• Indicate fetal well being
• They are typically caused due to fetal movement or contractions

Answer 16

Accelerations

Question 17

Normal range of fetal heart rate

Answer 17

110-160 bpm

Question 18

Irregular fluctuations or waves in the fetal heart rate baseline.

Answer 18

Variability

Question 19

Absent Variability

Answer 19

Amplitude range undetectable (flat line)
- The fetus is not responding well to contractions, birth process, etc.
- Fetal hypoxemia

Question 20

Minimal Variability

Answer 20

Amplitude Range: < 5 bpm
May be due to:
- The fetus sleeping
- Maternal tachycardia
- Certain medications
- Congenital anomalies

Question 21

Moderate Variability

Answer 21

Amplitude Range: 6–25 bpm
- Indicates fetal well-being

Question 22

Marked Variability

Answer 22

Amplitude Range: > 25 bpm
Cause not completely known
May be due to:
- Hypoxia
- Baby stressed while going through the birth canal

Question 23

Uterine Contractions: Duration

Answer 23

BEGINNING of the contraction to the END of the same contraction.
Interpretation:
- Lasts 45–80 seconds
- Should not exceed 90 seconds

Question 24

Uterine Contractions: Frequency

Answer 24

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

Question 25

Uterine Contractions: Intensity

Answer 25

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)

Question 26

Uterine Contractions: Resting Tone

Answer 26

TENSION in the uterine muscle between contractions
Interpretation:
* Average: 10 mmHg
* Should not exceed 20 mmHg
Soft = good; Firm = not resting enough