Abnormal Labor Flashcards
(32 cards)
What are the stages of labor?
First stage = onset of labor up to full cervical dilation (10cm)
Second stage = from full cervical dilation up to delivery of the baby
Third stage = from delivery of the baby to delivery of the placenta
What are the phases of labor curve?
Latent phase = from 0-4 cm cervical dilation
Active phase = early and true active phase
What are the subdivided active phases?
Early active phase = from 4-6cm cervical dilation
True active phase = from 6-8cm cervical dilation
Deceleration Phase = from 8-10cm cervical dilation; dilation is slower compared tot he true active phase
what are the common patterns of abnormal labor?
Arrest disorders = cervical dilation stops (cannot diagnose in <6cm cervical dilation)
Descent disorders = problem with how the presenting part/head is descending (after 8cm)
What are the divisions of labor?
Preparatory = 0-6cm cervical dilation
DIlatational = 6-8cm cervical dilation
Pelvic = 8cm to delivery of the baby
What is the main characteristic of Dystocia?
Abnormally slow progress of labor
What are the different complications that can occur due to Dystocia?
Infection
Uterine atony
Uterine rupture
Pathologic retraction ring
Fistula
Pelvic floor injury
LE nerve injury
Fetal injury
What is an initial response of the contracting uterus to an obstruction?
Pathologic retraction ring
- extreme thining of the lower uterine segment (seen in obstructed labor)
What are the 3 important causes of dystocia?
Power = uterine contractions
Passenger = baby
Passage = pelvis
What is the expected presentation for px with dystocia?
Cephalic presentation
What are the diff measurements of the diameter of the baby’s head?
Occipitomental diameter = longest diameter
Occipitofrontal diameter= aka fronto-occipital & mentoccipital
Suboccipitobregmatic diameter
Biparietal diameter = transverse diameter
What is the poorest prognosis for vaginal delivery?
If the mento-occipital diemeter can be measured
Face is presented
What is the military presentaiton?
Aka sinciput presentation where the head does not flex
What is the best position for babys during vaginal deivery?
Occiput presentation
What is the compound presentation?
Hand goes out first during crowning => does not affect eate of vaginal delivery
What is the transverse lie presentation?
Baby is perpendicular to the longitudinal axis of the mom
+
Should be assessed by Leopold’s maneuver
What can be used to augment labor when uterus is hypotonic?
Oxytocin
What aer the types of abnormalities in power?
Hypotonic uterine dysfunction = uterus is not contracting very well
Hypertonic or incoordinate uterine dysfunction = leads to fetal injury or nonreassuring fetal status
What are the causes of hypotonic uterine dysfunction?
Epidural analgesia = given during active phase
Infection
Maternal positioning during labor = better if px stands and walks to improve uterine contracitons
Birthing position - squatting best position
What happens during hypertonic or incoordinate uterine dysfunction?
Strong but irregular interval of contractions
What are the measurements of the pelvic inlet?
Diagonal conjugate = measured from the inferior border of the pubic symphysis to the sacral promontory
- biparietal diameter: place where the baby passes through the inlet
What is the measurement used for midplane?
Interspineous or bispinous diameter = posterior sagittal diameter
What is the measurement used for the pelvic outlet?
2 ischial tuberosities: Fist is used
Are nulliparas or multiparas more prone to dystocia?
Nulliparas = longer latency, slwoer protraction, longer arrest periods than multiparas
