Flashcards in Ch 13-14 Labor & Birth Processes Deck (45)
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1
Factors Influencing Labor Initiation
- Uterine stretch
- Progesterone withdrawal- pregnancy mx hormone
uterus gets crampy and then goes into labor
- Increased oxytocin sensitivity
- body’s natural hormone that is UTERUS specific and makes it contract
- nipple stimulation is #1 method to increase oxytocin
Pro: When done in moderation, it can get labor going
Con: no control on amount of oxytocin you produce. Can hyperstimulate uterus
- Increased release of prostaglandins
- softens cervix and thins it out, effaces
2
Premonitory signs of labor
cervical chgs
lightening (relief)
increased energy (nesting)
bloody show (mucus plug)
braxton hicks
spontaenous rupture of membranes (water break)
3
Regular
Stronger over time
Increasing discomfort
UC’s continue despite position
5 min apart x2 hours
true labor
4
Irregular
No increase in intensity
Localized pain (front)
UC’s come and go with position changes
Fluids helps
false labor
5
5 p's
Passenger - this is where position of baby is covered
Passageway
Powers
Position - most confusing - of the MOTHER, not of fetus
Psyche (psychological response)
6
Passenger (fetus)
size (macrosomia)
presentation
lie
attitude
position
placenta
7
what can you ask mom to do if baby is LOT?
positioning
8
If diamond is closer to anterior and triangle is posterior, it is ...
OP
9
If diamond is L and triangle is R, it is ...
LOT
10
most desirable position & presentation
cephalic, OA
11
the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother
(longitudinal vs transverse)
Lie
12
which is most subjective
station
13
is true cephalopelvic disproportion common or rare?
COMMON
14
who would have problems w/ cervical dilation?
those w/ a leap
anyone w/ HPV w/ tissue removal
anyone w/ D&C or D&E (scar tissue)
15
what is a good indication that someone's pelvic msks are strong?
good shape
16
effacement
shortening
17
dilation
opening of cervix
18
Cardinal movements
EDFI
ExExEx
19
entering of the biparietal diameter (widest) into the pelvic inlet.
Engagement
20
The baby's head (presenting part) moves deep into the pelvic cavity and is commonly called lightening. – greatest at deceleration phase of 1st stage and during 2nd stage of labor
descent
21
occurs during descent, brought about by resistance felt by the baby’s head against the soft tissues of the pelvis. Smallest diameter of the baby’s head presents into the pelvis
flexion
22
head reaches pelvic floor & rotates to accommodate for changes in diameter of the pelvis. Baby must move from sideways to facing posterior
internal rotation
23
head passes through pelvis at nape of neck and there is a rest. Occurs as head, face, and chin are born
extension
24
after baby’s head comes out, it sucks back in a little & rotates to face down
external rotation
25
last big relieving push which results in baby
expulsion
26
Involuntary uterine contractions
primary powers
27
PUSHING
Bearing-down efforts
Augment the primary powers
secondary powers
28
responsible for effacement and dilation
divided into frequency
duration
intensity
primary
29
not letting the patient push so that primary powers can work baby down further into pelvis
effective for only 1 hr
longer the labor, the greater the risk of infx.
laboring down
30