Second Stage Labor UTD Flashcards
What is the second stage of labor?
From complete cervical dilation to delivery of the fetus.
What are the cardinal movements of labor?
Engagement, descent, flexion, internal rotation, extension, restitution, expulsion.
How often is FHR monitored during second stage (low-risk)?
Every 15 minutes.
How often is FHR monitored during second stage (high-risk)?
Every 5 minutes.
When should vaginal exams be performed?
Every 1–2 hours or as clinically indicated.
What is early (immediate) pushing?
Pushing initiated as soon as full dilation is confirmed.
What is delayed pushing (laboring down)?
Waiting to push until fetal descent occurs, despite full dilation.
What are risks of delayed pushing?
Longer second stage, increased chorioamnionitis, low cord pH.
What is the recommended pushing technique?
Spontaneous pushing unless neuraxial block impairs effort.
Is Valsalva pushing recommended?
No, it causes transient maternal cardiovascular effects without benefit.
What maternal positions are encouraged?
Upright, semirecumbent, lateral; avoid supine.
What are benefits of upright positions?
Reduced episiotomy and assisted delivery rates, shorter second stage.
Do warm compresses help prevent tears?
May reduce 3rd/4th-degree tears; evidence is limited.
What is the hands-on technique at delivery?
Manual control of head flexion and perineal support during crowning.
When is episiotomy indicated?
Restrict use to clinical need; mediolateral preferred.
How is nuchal cord managed?
Slip over head or clamp and cut if not reducible.
When is second stage considered prolonged in nulliparas?
After 3 hours (or 4 with epidural).
When is second stage considered prolonged in multiparas?
After 2 hours (or 3 with epidural).
Is fundal pressure recommended?
No, due to risk of trauma and lack of benefit.
Is routine suctioning needed at birth?
No, unless airway is obstructed.
Is water birth recommended?
No, due to risk of infection despite unclear benefits.
When is assisted vaginal delivery indicated?
Fetal compromise, prolonged second stage, maternal exhaustion, or medical indication.
