processes of labor Flashcards
why do nurses feel cervix in LND
to see the position of the baby we want to feel : back of head (do not want to feel eyebrows or eyes)
land marks of fetal skull
mentum, sinicput, bregma, vertex, posterior fontanelle, occiput
we want the baby to be in
flexion fetal atittuide
do not want the baby to be
extension
fetal lie should be
longitudinal (parallel) head down
fetal lie should not be
transverse (right angles)
fetal presentation
Determined by fetal lie and by the fetal body part entering pelvis first
should be: cephalic for vaginal delivery
cephalic variations
vertex (easiest), military, brow, face
vertex cephalic
head flexed (easiest) occiput presents
military cephalic
head straight, top of head presents
brow cephalic
head extended sinciput presents
face cephalic
head hyper-extended, face presents
breech (butt and legs)
presenting in the pelvic (c-section)
frank, complete, footling
frank breech
legs against body, buttocks first
complete breech
all flexed, buttocks and feet first
footling breech
extended legs, one or two feet first
shoulder
c-section; fetus is a transverse lie
engagement
when largest diameter of the presenting part is in the pelvic inlet
station
relationship of presenting part of ischial spines
fetal position
relationship of presenting part landmarks to maternal pelvis
baby is engaged at…
at level station 0 (ishial spine)
engaged baby
The biparietal diameter (B P D) of the fetal head is in the inlet of the pelvis. In most instances, the presenting part (occiput) will be at the level of the ischial spines (0 station) - babies head cannot be pushed away
ischial spine is at ____ station
zero
fetal position
occiput - back of head
mentum- chin
sacrum - butt
acromino - shoulde r
anterior landmark
babies bakc is going ot be facing moms betlly
posterior landmark
babys back is going to be towards moms back (back to back) – well have to reach far back to feel occiput
presentation
is the fetal body part entering the pelvis first
position
is the relationship of presenting part landmarks to maternal pelvis
3 phases of contractions
increment, acme, decrement
contraction are measured in mm Hg using…
IUPC - to see if contractions are strong enough
intrauterine pressure catheter
labor usually begins when
between 38-42 weeks gestation
no full understanding of cause of labor
effacement
drawing up of cervix; Occurs from longitudinal traction of cervix with contractions and Cervix goes from thick to paper thin (described in %)
dilation
opening up cervix; Uterus elongates and straightens fetal body and pushes baby/amniotic sac against cervix –> this causes cervix to open (up to 10cm)
Effacement of the Cervix in the Primigravida (1)
At the beginning of labor, there is no cervical effacement or dilatation. The fetal head is cushioned by amniotic fluid.
Effacement of the Cervix in the Primigravida (2)
Beginning cervical effacement: As the cervix begins to efface, more amniotic fluid collects below the fetal head.
Effacement of the Cervix in the Primigravida (3)
Cervix is about one-half (50%) effaced and slightly dilated. The increasing amount of amniotic fluid below the fetal head exerts hydrostatic pressure on the cervix.
Effacement of the Cervix in the Primigravida (4)
Complete effacement and dilatation.
why do we need to know what time woman’s water broke
infection
main difference b/w true and false labor
in true labor, after walking around for awhile there IS PROGRESS SOME CHANGE
true labor
- Regular UCs
- UCs get closer
- UCs longer/harder
- Pain radiates
- More intense with walking
- No decrease in UCs w/ bath & rest
- Progressive cervical changes!
false labor
- Irregular UCs
- Not closer
- Not longer/harder
- Pain in abdomen
- No effect or decrease intensity with walking
- Rest & bath eases UCs
-No cervical changes
