T2-Process of Labor and Birth Flashcards
What are the 5Ps?
Passenger Passageway Powers Position of the mother Psychologic response
The part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor. The presenting part is the part of the fetus that lies closet to the internal os of the cervix
Fetal presentation
What are the 3 types of fetal presentations?
What are the 4 types of presenting parts?
Fetal presentations:
- Cephalic (vertix)
- Breech
- Shoulder
Presenting parts:
- Occiput
- Mentum
- Sacrum
- Scapula
What presentation has to be delivered C-section?
Shoulder presentation
The relation of the long axis of the fetus to the long axis of the mother
Fetal lie
What are the two types of fetal lies?
Longitudinal (vertical)
Transverse
What type of fetal lie has to be delivered C-section?
Transverse
The relation of the fetal body parts to one another
Fetal attitude
What is the most common type of relationship (attitude)?
General flexion
The relationship of a reference point on the presenting part to the 4 quadrants of the mothers pelvis
Fetal position
The relationship of the presenting part to an imaginary line drawn between the maternal ischial spines and is a measure of the degree of descent of the presenting part of the fetus through the birth canal; measured in cm
Station
Term used to indicate that the largest transverse diameter of the presenting part (usually BPD) has passed through the maternal pelvic brim or inlet into the true pelvis and usually corresponds to station 0
Engagement
What are the 4 pelvic shapes?
Gynecoid
Android
Anthropoid
Platypelloid
What is the most favorable pelvis for birth?
Gynecoid
What do the primary powers signal?
Beginning of labor
What do the primary powers cause?
Effacement and dilation of the uterine cervix
Shortening and thinning of the cervix during the first stage of labor
Effacement
____ usually precedes _____ in the nulliparous woman
Effacement usually precedes dilation in the nulliparous woman
The enlargement or widening of the cervical opening and the cervical canal that occurs once labor has begin;
Dilation
Secondary powers: Once te cervix has dilated, voluntary, _______ efforts augment the force of involuntary contractions
Bearing down
Which part of the uterus is the one exerting the force of the contraction: lower or upper?
Upper uterine segment
Maternal urge to bear down
Ferguson reflex
What are the premonitory signs of impending labor? (8)
- Stronger braxton hicks
- Lightening
- Backache
- Increased energy
- Ripening of cervix
- Mucus plug expelled
- Bloody show
- Others: Weight loss (1-3.5 lbs), sometimes NVD and indigestion; possible ROM
What stage of labor?
Lasts from onset of UC to full effacement and dilation
Stage 1
Stage 1: Latent phase
More progress in ______ of cervix and little increase in _____; UC gradually increase
More progress in effacement; little increase in descent
Stage 1: Active phase
(Rapid or slow) dilation of the cervix and (increase or decreased) rate of descent of presenting part; UC gradually increase
Rapid dilation of cervix and increased rate of descent of presenting part
Stage 1: Transition phase
Rapid dilation of the cervix and increased rate of the presenting part; strongest contractions; What is cervix like? Effacement?
Cervix: 7-10 cm
Effacement: Almost complete
Stage 2 of labor lasts from the time the ______ to the _____
Cervix is fully dilated to the birth of the fetus
Stage 3 of labor is from _____ to _____
Birth of fetus till placenta is delivered
What are the signs of placenta separation?
- Cord lengthens
- Uterus changes shape to globular
- Gush of blood from vagina
What is stage 4 of labor?
Delivery of placenta to at least the first 2 hours after birth
What are the 7 cardinal movements?
Engagement Descent Flexion Internal rotation Extension External rotation (restitution) Birth by expulsion
What are 4 factors that affect fetal circulation during labor?
Maternal position
Uterine contractions
Maternal BP
Umbilical cord blood flow
