Week 1 Flashcards
plotting cervical dilation against time as a method of graphically analyzing labor.
Friedman’s Curve
1st Stage, Active Phase - 3 subphases
Acceleration Phase
Phase of maximum Slope
Deceleration Phase
Prelabor Phenomenon (8)
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
Latent Phase of Labor
onset of regular ctxns to 3-4 cm dilation 8hrs primip 5-6 hrs for multips
Transition Phase of 1st Stage
7-10cms
Rate of cervical dilation for active phase - Primip
1.2cm / hr
Rate of cervical dilation for active phase - Multip
1.5 cm/hr
Rate of descent active phase - primip
1cm/hr
Rate of descent active phase - multip
2cm / hr
Length of second stage primip
less than or equal to 2hr
3hr if epidural
Length of second stage multip
less than or equal to 1 hour
2hr if epidural
Length of third stage
less than or equal to 30 minutes
7 cardinal movements of labor
- engagement
- descent
- flexion
- internal Rotation
- extension
- external rotation
- expulsion
Varney’s 12 Basic Management Decisions
- PO Intake 7. FHR assessment
- IV access 8. Frequency of vaginal exams
- Position or ambulation limitations 9, Labor partnets
- Medications 10, AROM
- Epidural 11. Collaboration
- Maternal VS 12, Prep for delivery
Anterior asynclitism
sagittal suture towards the sacral promAnterior asunclitismontory,
more of the anterior parietal bone presents itself
Posterior Asynclitism
the sagittal suture lies close to the symphysis
more of the posterior parietal bone will present
Curve of Carus
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
Biparietal diameter
the largest transverse diameter of the fetal head
9.5 cm
Platypelloid Pelvis
- 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%
Android Pelvis
- 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)
Anthropoid Pelvis
- oval shape
- greater A/P diameter
- straight walls
- small pubic arch, large sacrosciatic notches
- deep non-obstructed pelvis
- 25-50% (more non-white)
- Gynacoid Pelvis
- 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
Active Phase - Define deceleration phase
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
Active Phase - Define Phase of Maxiumum Slope
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
