Preparation for Labor Flashcards
What are the preliminary signs of Labor?
Lightening
Slight loss of weight
Backache
Excess energy
Braxton Hicks Contractions
Ripening of the Cervix
Lightening occurs approximately _____ before labor begins
10-14 days
Lightening gives the woman relief from the ________ and ________
diaphragmatic pressure
shortness of breath
This increase in urine production can lead to weight loss between ______ lbs
1-3 lbs
This increase in activity is related to a boost in ______ release, which is initiated by a decrease in progesterone production by the placenta
epinephrine
What are the signs of True Labor?
Uterine Contractions
Show
Rupture of membrane
true labor contractions begin in the back and sweep forward across the abdomen similar to the tightening of a rubber band.
Uterine Contractions
as the cervix softens and ripens, the _____ that filled the cervical canal during the pregnancy is expelled.
mucus plug
The exposed cervical capillaries seep blood as a result of pressure exerted by the fetus. This blood, mixed with mucus, takes on a pink tinge and is referred to as ______
show or bloody show
A woman should telephone her healthcare provider immediately when her membranes rupture as two risk are associated with ruptured membranes:
1.
2.
- intrauterine infection
- prolapse of the umbilical cord
works together with prostaglandins to initiate contractions
oxytocin
What are the components of labor?
4Ps
Passage
Passenger
Power
Psyche
The cranium, the uppermost portion of the skull is composed of eight bones. What are these?
4 SUPERIOR bones
1. frontal
2. 2 parietal
3. occipital
4 bones of the skull
1. sphenoid
2. ethmoid
3. 2 temporal bones
are the bones important in childbirth.
four superior bones
Biparietal or transverse diameter
9.5 cm
Suboccipitobregmatic measurement(smallest AP diameter)
9.5 cm
Occipitofrontal diameter
12 cm
Occipitomental diameter
13.5 cm
spaces compress during childbirth to aid in molding of the fetal head.
fontanelles
is overlapping of skull bones along the suture lines which causes a change in the shape of the fetal skull to one long and narrow, a shape that facilitates passage through the rigid pelvis.
molding
describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other
fetal attitude
when a fetus is in complete flexion:
the spinal column is bowed forward,
the head is flexed forward so much that the chin touches the sternum,
the arms are flexed and folded on the chest, the thighs are flexed onto the abdomen
the calves are pressed against the posterior aspect of the thighs.
Good fetal attitude
Fetus is in _______ if the chin is not touching the chest but is in an alert or military position
moderate flexion
Fetus in _______ presents the “brow” of the head to the birth canal
partial extension
Fetus in _________ , the back is arched and the neck is extended, presenting the occipitomental diameter of the head to the birth canal (face presentation).
complete extension
is the relationship between the long (cephalocaudal) axis of the fetal body and the long axis of a woman’s body- in other words, whether the fetus is lying in a horizontal lie (transverse) or vertical (longitudinal) position.
fetal lie
What are the three fetal presentation?
Cephalic
Breech
Shoulder
the most frequent type of presentation, occurring as often as 96% of the tie, the fetal head is the body part that comes first contacts the cervix.
Cephalic Presentation
What are the four types of cephalic presentation?
a. vertex
b. brow (military position)
c. face
d. mentum (chin)
means either the buttocks or the feet are the first body parts that will contact the cervix.
breech presentation
What are the three types of breech presentation?
complete breech
frank breech
footling
the fetus has the thighs tightly flexed on the abdomen; both the buttocks and the tightly flexed feet present to the cervix
complete breech
attitude is moderate because the hips are flexed, but the knees are extended to rest on the chest. The buttocks alone present to the cervix.
frank breech
neither the thighs nor lower legs are flexed. If one foot presents, it is a single-footling breech, if both present, it is a double-footling breech.
footling
A fetus lies horizontally in the pelvis so the longest fetal axis is perpendicular to that of the mother.
shoulder presentation
The presenting part of the shoulder presentation is usually _____
acromion process
iliac crest
hand or elbow
Is the relationship of the presenting part to a specific quadrant and side of a woman’s pelvis.
fetal position
Maternal pelvis is divided into 4 quadrants
- right anterior
- left anterior
- right posterior
- left posterior
refers to the settling of the presenting part of a fetus far enough into the pelvis that it rests at the level of the ischial spine. , the midpoint of the pelvis.
engagement
A presenting part that is not engaged is said to be
floating
One that is descending but has not yet reached the ischial spines may be referred to as
dipping
Refers to the relationship of the presenting part of the fetus to the level of the ischial spines
station
0 station
ischial spine
above the spine station
-1 to -4 cm
below the ischial spine station
+1 to +4 cm
At what station the presenting part is at the perineum and can be seen if the vulva is separated (it is crowning)?
+3 or +4
Cardinal Movements of labor
Descent
Flexion
Internal Rotation
Extension
External Rotation
Expulsion
is shortening and thinning of the cervical canal.
Effacement
enlargement or widening of the cervical canal from an opening a few millimeters wide to one large enough to permit passage of a fetus.
Dilatation
takes (begins with the initiation of true labor contractions and ends when the cervix is fully dilated). It is 12 hours to complete.
First stage of Labor
What are the three phases of first stage of labor?
latent phase
active phase
transition phase
begins at the onset of regularly perceived uterine contractions and ends when rapid cervical dilatation begins.
latent phase
Contractions during latent phase are ______, lasting ______
mild and short
lasting 20-40 seconds
Cervical effacement occurs and the cervix dilates minimally (1-3 cm).
Latent phase
cervical dilatation (4-7cm) occurs more rapidly. Contractions grow stronger, lasting 40 to 60 seconds, and occur approximately every 3-5 minutes. Show (increased vaginal secretions) and perhaps spontaneous rupture of the membranes may occur during this time
active phase
is the time span from full dilatation and cervical effacement to birth of the infant.
second stage
the fetus begins descent and as the fetal head touches the internal perineum to begin internal rotation, her perineum begins to bulge and appear tense.
second stage
opens and the fetal scalp appears at the opening to the vagina and enlarges from the size of a dime to a quarter, then a half-dollar.
crowning
the placental stage begins with the birth of the infant and ends with the delivery of the placenta.
Third stage
two separate phases are involved in the third stage
placental separation
placental expulsion
What are the signs of placental separation?
Lengthening of the cord
Sudden gush of vaginal blood occurs
Placenta is visible at the vaginal opening
uterus contracts and feels firm
if the placenta separates first at its center and lastly at its edges, it tends to folds on itself like an umbrella and presents at the vaginal opening with the fetal surface evident.
Schultze presentation
if the placenta separates first at its edges, it slides along the uterine surface and presents at the vagina with the maternal surface evident.
Duncan Presentation
