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Intrapartum/Postpartum Wks 1-4 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

plotting cervical dilation against time as a method of graphically analyzing labor.

A

Friedman’s Curve

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2
Q

1st Stage, Active Phase - 3 subphases

A

Acceleration Phase

Phase of maximum Slope

Deceleration Phase

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3
Q

Prelabor Phenomenon (8)

A

Lightening

Engagement

Increase in vaginal secretions

Loss of weight—not uncommon

Bloody show Cervix softens/effaces

Lower backache may be present

Increase in strength and frequency of contractions

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4
Q

Latent Phase of Labor

A

onset of regular ctxns to 3-4 cm dilation 8hrs primip 5-6 hrs for multips

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5
Q

Transition Phase of 1st Stage

A

7-10cms

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6
Q

Rate of cervical dilation for active phase - Primip

A

1.2cm / hr

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7
Q

Rate of cervical dilation for active phase - Multip

A

1.5 cm/hr

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8
Q

Rate of descent active phase - primip

A

1cm/hr

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9
Q

Rate of descent active phase - multip

A

2cm / hr

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10
Q

Length of second stage primip

A

less than or equal to 2hr

3hr if epidural

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11
Q

Length of second stage multip

A

less than or equal to 1 hour

2hr if epidural

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12
Q

Length of third stage

A

less than or equal to 30 minutes

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13
Q

7 cardinal movements of labor

A
    1. engagement
    1. descent
    1. flexion
    1. internal Rotation
    1. extension
    1. external rotation
    1. expulsion
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14
Q

Varney’s 12 Basic Management Decisions

A
    1. PO Intake 7. FHR assessment
    1. IV access 8. Frequency of vaginal exams
    1. Position or ambulation limitations 9, Labor partnets
    1. Medications 10, AROM
    1. Epidural 11. Collaboration
    1. Maternal VS 12, Prep for delivery
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15
Q

Anterior asynclitism

A

sagittal suture towards the sacral promAnterior asunclitismontory,

more of the anterior parietal bone presents itself

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16
Q

Posterior Asynclitism

A

the sagittal suture lies close to the symphysis

more of the posterior parietal bone will present

17
Q

Curve of Carus

A

the lower exiting end of the pelvic curve. the fetus and placenta must follow this curve in order to be born.

Directs the head upward to the vulval outlet

Birth of the shoulders and body is by laterla flexion via the curve of carus

18
Q

Biparietal diameter

A

the largest transverse diameter of the fetal head

9.5 cm

77
Q

Platypelloid Pelvis

A
  • Transversally wide, anteriorly wide
  • flattened shape
  • short sacrum that curves inwards, reducing the diameters of the lower pelvis
  • reduced AP diameter
  • problematic for birth
  • < 3%
78
Q

Android Pelvis

A
  • Female pelvis with masculine features
  • wedge or heart shaped inlet
  • prominent sacrum and triangular anterior segment
  • reduced pelvic outelt causes birth problems
  • 15-30% (more white women)
79
Q

Anthropoid Pelvis

A
  • oval shape
  • greater A/P diameter
  • straight walls
  • small pubic arch, large sacrosciatic notches
  • deep non-obstructed pelvis
  • 25-50% (more non-white)
80
Q
  • Gynacoid Pelvis
A
  • Normal female Pelvis
  • Inlet is oval with greater transverse diameter or round
  • Interior walls are straight
  • suprapubic arch is wide
  • sarum shows averave backward inclination
  • greater sciatic notch is well rounded
  • well proportioned and accommodates birth
  • 50 % of women
81
Q

Active Phase - Define deceleration phase

A

at the end of the active phase - the rate of dilation slows and the cervix dilates 8-10 cms while descent reaches its maximum rate.

primip - average rate of descent 1.6cm/hr not slower than 1

multip - average rate of descent 5.4 cmhr not slower than 2.1

82
Q

Active Phase - Define Phase of Maxiumum Slope

A

the time when cervical dialtion is occurring most rapidly, and increasing from 3-4cm toabout 8.

primip - average 3cm/hr but not slower than 1.2cm/hr

multip - average 5.7 cm/hr, not slower than 1.5cm/hr

83
Q

Active Phase - define Acceleration Phase

A

Starts the active phase around 4 cms and leads

84
Q

10 - reasons for IV access

A
    1. grand multip 6. pitocin
    1. dehydrated 7. previous post partum hemorrhage
    1. at risk for bleeding 8. maternal fever
    1. life threatening condition (previa/abruption etc.) 9. Epidural analgesia/anesthesia
    1. GBS positive 10. over distended uterus
85
Q

reasons for vaginal exams

A
  1. upon admission
  2. prior to medication administration
  3. prior to pushing to confirm complete dilation
  4. after SROM
  5. non-reassuring FHR pattern
86
Q

Indicaitons for amniotomy

A
  1. place internal monitors
  2. delivery is imminent
  3. stimulate labor
  4. facilitate fetal descent

Intrapartum/Postpartum Wks 1-4 (1 decks)

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