Physiology of Labor and Birth: 10 DONE Flashcards
Identify the 4 stages of labor
First stage
*When labor begins and continues until the cervix is fully open (10 cm) and thin (100%)
* Three phases: latent, active, transition
Second stage
*When the cervix is fully open until the baby is born.
*urge to bear down/ push
Third Stage
*From birth of fetus until delivery of placenta
Fourth stage
*From delivery of placenta until 2 hours postpartum
cm dilated and contractions how many min apart?
Latent?
Active?
Transition
Latent: 0-6 cm
contractions 5-20 min apart, mild
Active: 6-8 cm
3-5 min apart, moderate-strong
Transition: 8-10 cm
2-3 min apart, strong
True labor?
What kind of change?
Where are contractions felt?
Contractions get?
What else happens?
Progressive cervical change
Contractions felt in back and abdomen
Contractions get longer/stronger /closer together
bloody show and Rupture of membranes
False labor
Cervical change?
Contractions felt where?
Contractions have?
Contractions stop how?
No cervical change
Contractions mostly felt in lower abdomen
Contractions have little to no pattern and do not get stronger
Contractions stop with hydration or activity
What are the 3 questions asked when a patient comes in for labor?
How is baby moving?
Are you having any vaginal bleeding?
Are you leaking any fluid?
Describe data collected during the initial assessment of the laboring patient.
-What is their indication for labor?(contractions, rupture of membranes (ROM), etc.)
-Fetal heart rate and contraction assessment (frequency, duration, intensity, rest)
-Cervical exam (dilation, effacement, station, and presenting part)
-Vital signs
-Thorough past medical and surgical history
-Any issues with current pregnancy (hypertension, diabetes, etc.)
-Current medication use
-Allergies
-Assessment (heart, lungs, edema, DTRs, etc.
Understand the 4 P’s that affect the labor and birth process
Focus on Passenger
Occiput posterior?
Occiput anterior?
FOCUS ON PASSENGER!!!! The question was like what does the vagina do when the baby is coming out? Answer: it molds to fit the baby’s head.
**Passenger fetus and placenta.
– Passageway: Mother’s pelvis, which the baby passes through during labor.
Baby face faces paet
Baby faces faces back (ideal)
– Powers: Uterine contractions and the mother’s pushing efforts.
– Psychologic response: Mother’s psychological state during labor
Fetal monitoring
List acceptable fetal heart rate and variability criteria
KNOW THIS!!!!
110-160 beats per minute
Absent
Minimal (less than 5 bpm)
Moderate (5-25 bpm)
Marked (> 25 bpm)
What are declarations?
What are early declarations?
Caused by?
What can u do?
What are variable declarations?
Caused by?
What can u do?
KNOW THIS!!!!
Periods when the fetal heart rate (FHR) temporarily slows down.
Early: mirror contractions, benign, often caused by fetal head compression, no intervention needed
Variable: Sharp, abrupt decrease in heart rate, Often caused by umbilical cord compression, does not need to be related to contraction. Can change position and amnioinfusion
What are late declarations?
Caused by?
What can u do?
KNOW THIS!!!!
Start after the contraction has peaked, gradual decrease
Can be caused by poor placental perfusion, hypoxia, maternal
hypotension, tachysystole (more than 5 contractions in 10 minutes), infection, etc.
Change position, fluid bolus, stop pitocin, notify provider
Apply terminology used to describe
contractions including
frequency?
duration?
intensity?
KNOW THIS!!!!
Frequency:
How often contractions occur, measured from the start of one contraction to the start of the next.
Duration:
How long each contraction lasts, measured from the beginning to the end of a single contraction.
Intensity:
The strength of the contraction, typically described as mild, moderate, or strong.
SROM (spontaneous rupture of membranes)
note?
Can use?
– Note color, odor, amount, time (COAT)
– Can use bedside diagnostic tests to confirm SROM
AROM (artificial rupture of membranes)
note?
fetal head should be?
procedure known as?
can be used to?
– Note color, odor, amount, time (COAT)
– Fetal head should be well engaged in pelvis to prevent cord prolapse
– Procedure is known as amniotomy
– Can be used to augment/strengthen labor
