Process Of Labor Flashcards by Maii Mahmood

Collagen fibers in cervix is broken down by enzyme collage base and elastase.

Increase in water content of cervix

Stretching and effacement

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Stimulate uterine contraction - to permit softening, stretching, and thinning of cervix.

Estrogen

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Produced by placenta to relax uterine smooth muscle, resulting in no uterine contraction.

Progesterone

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Induction of labor after vaginal application

Prostaglandin

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To stop preterm labor

Prostaglandin inhibitors

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Stimulates synthesis of prostaglandin

Corticosteroid

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Fetus begin to settle into pelvic inlet

Lightening

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Irregular intermittent contraction occurring throughout pregnant like menstrual cramps.

Braxton hick contractions

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Rigid, firm cervix softens or ripens

Cervical changes

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Impending labor in 24-48hrs

Mucus plug is expelled due to softening and effacement resulting in pink tinged secretions

Bloody show

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After rupture, must go into labor within 24hr, otherwise labor is induced

Rupture of membranes ROM

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Progressive dilatation and effacement of cervix
Contractions regular and increases in frequency
Pain starts from back radiates to abdomen
Walking intensifies pain

True labor

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No change
Contractions irregular
Discomfort in abdomen
Giving rest and warm bath lessen contractions

False labor

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The longest stage, between the onset of labor till the point of cervical dilation and effacement

First stage of labor

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Expulsion of fetus stage

Second stage of labor

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Delivery of placenta stage

Third stage of labor

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1st four hours after delivery. (Post delivery of placenta)

Fourth stage of labor

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The 5Ps of labor?

Passage
Passenger
Position
Powers
Psychologic response

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Size of maternal pelvis
Type of pelvis
Ability of the cervix to dilate and efface
Ability of vaginal canal and external opening of the vagina (introitus) to distend

Passageway

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Major pelvis

False pelvis

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Minor pelvis

True pelvis

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Middle of the sacral promontory to sub pubic angle

Diagonal conjugate 12.5cm

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Middle of sacral promontory to middle of pubic crest

Conjugate Vera or true conjugate 1cm

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Middle of sacral promontory to 1cm below pubic crest

Obstetric conjugate 1.5/2cm

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Transverse diameter size?

13.5cm

Oblique diameter size?

12.75cm

Pelvis diameters favorable to vaginal delivery, inlet rounded

Gynecoid

Male pelvis, heart shaped inlet

Android

Inlet is oval shaped

Anthropoid

Flat pelvis with inlet transverse oval

Platypelloid

As labor progresses, this portion thickens and shortens.

Upper portion

As labor progresses this portion expands and thins out

Lower portion

Is the taking up of the internal os and cervical Cana into the uterine side wall.

Effacement

Uterine muscle remains short and thick, and does not return to original length is called..

Brachystasis

Cervical dilatation measurement?

1-10cm

3 major parts of passenger?

Face, base of skull (cranium) and vault (roof)

The vault has movable bones that overlap under pressure, and is called..

Molding

Are membranous spaces between cranial bones (frontal, sagittal, coronal, lambdoidal sutures

Sutures

The intersection of cranial structure or soft spot of the baby's head is called..

Fontanelles

Anterior fontanelles/ Bregma close within?

18months

Posterior fontanelles close by..

8-12weeks

Mentum

Fetal chin

Sinciput

Anterior area, brow

Vertex

Area between anterior and posterior fontanelles

Occipitobregmatic

Behind posterior fontanelles, occipital bone

Relationship of fetal parts to one another, general flexion

Fetal attitude

Relationship of the spinal column of fetus to the spinal column axis of the mother

Fetal lie

Determined by the fetal lie and by the body part that enters the pelvic passage first.

Fetal presentation

Portion that is felt through the cervix on the vaginal examination is called..

The presenting part

Common, labor and birth proceed normally

Cephalocaudal

Difficult labor called malpresentation

Breech or shoulder

Complete flexion of the head,

Vertex presentation

No flexion, all extended

Military presentation

Fetal head in partial extension

Brow presentation

Fetal head in complete extension

Face presentation

Prolapse of the limb of the fetus alongside the head in cephalic presentation or breech presentation

Compound presentation

Fetal knee and hip are both flexed, thigh are on abd, calves are on posterior aspect of thighs, buttocks and feet of the fetus present in maternal pelvis

Complete breech

Fetal hips are flexed and knee are extended lying against the face, buttocks of fetus in maternal pelvis

Frank breech

Fetal legs and hips are extended, feet in maternal pelvis

Footling breech

Fetal shoulder is presenting part, fetus in transverse lie

Shoulder presentation

Presentation of the umbilical cord

Funis presentation

Placenta Previn

Placenta presentation

Refers to the relationship of the presenting part to an imaginary line drawn at the ischial spines of the maternal pelvis

Station

If presenting part is higher than the ischial spines the statin has a..

Negative number

Presenting part has passed the ischial spines

Positive numbers

Is uterine muscle contraction

Primary force

Use of abdominal muscles to push during 2nd stage of labor

Secondary force

Rhythmic tightening and shortening of uterine muscles during labor

Contraction

Building up of contractions

Increment

Peak of contraction

Acme

Letting up of contraction

Decrement

Between contraction is relaxation period

Resting period

Time between beginning of one contraction to beginning of the next

Frequency

Beginning of completion of single contraction 30-40secs

Duration

Strength of the contractions

Intensity

Contraction characteristics are measured by

Intrauterine catheter

After cervical dilatation maternal abdominal muscle contract as the women pushes. This pushing is to aid expulsion of the fetus and placenta

Bearing down

Presenting part is freely moveable above inlet

Floating / ballotable

Presenting part begins to descend into inlet, before engagement has truly occured is called..

Dipping into pelvis