Week 3 Lecture Flashcards
What is labour?
Labour is the process of moving the fetus, placenta, and membranes out of the uterus and through the birth canal.
What is labour?
Labour is the process of moving the fetus, placenta, and membranes out of the uterus and through the birth canal.
What are the factors involved in the onset of labour?
Changes in maternal uterus, cervix, and pituitary gland (maternal and fetal)
How are the hormones affected during the onset of labour?
Increased estrogen, oxytocin (incr contractions) and prostaglandins
Decreased progesterone (this hormone maintains pregnancy)
What is effacement?
Shortening and thinning of the cervix during the first stage of labour. It is expressed from 0 to 100 percent.
- Ex: Effacement 50% (50% of cervix thin)
What is presentation?
The part of the fetus that enters the pelvic inlet first and leads through the birth canal.
What is presentation?
The part of the fetus that enters the pelvic inlet first and leads through the birth canal.
What is engagement?
The largest transverse diameter of the presenting part (biparietal diameter) has passed through the pelvic inlet into the pelvic cavity.
What is crowning?
The head or the presenting part appears at the vaginal opening.
What is crowning?
The head or the presenting part appears at the vaginal opening.
What is the station?
Relationship of presenting part to imaginary lines drawn between maternal ischial spines & measures the degree of decent
- 1 cm above the spines =minus 1.
- At the level of the spine = 0
- Birth imminent when the presenting part is +4 to +5
Contractions are occurring every 2.5 mins. Why is this relaxation period important?
Important so the fetus has time to relax/breathe (fetus has hypoxia during contractions)
What is GBS? What is the concern regarding GBS in vaginal deliveries? What are the risk factors? How is it treated?
1) Universal screening rectovaginal culture at 35-37 weeks
- Considered normal vaginal flora in a client who is not pregnant
- Present in 10-30% of healthy pregnant individuals
2) Concern about the vertical transition from the birth canal of the infected mother to the infant during birth.
3) Risk factors: preterm birth, PROM >18hours, intrapartum maternal fever, and positive history of early-onset neonatal GBS.
4) IV antibiotics prophylaxis (most often Penicillin G)
What is the protocol for HSV-positive mothers? What is the risk for the infant? What can be used to treat it?
1) If visible lesions are not present when labour begins, vaginal birth is acceptable. If they are, vaginal delivery cannot occur.
2) Infants born through an infected vaginal are at risk of neonatal herpes simplex virus.
3) Acyclovir and valacyclovir may be used in pregnancy to reduce the symptoms of HSV to suppress HSV close to the time of birth.
How do you assess ROM? How is it tested?
COAT
Colour (amniotic fluid = clear)
Odour (sweet smell)
Amount (show vs. large gush)
Time (document it)
Sterile speculum examination
Nitrazine or fern test to confirm ROM
