Healthy Pregnancy and Labor Flashcards by Cassie Howe

What are some preliminary signs of labor?

Lightening
increase in activity
slight loss in weight
backache
Braxton hicks
ripening of cervix

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What are some true signs of labor?

uterine contractions- regular, rhythmic, increase in intensity
bloody show
rupture of membranes
cervical dilation

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You dont want membranes ruptured for more than __ hours without the baby born because this can cause infection

no more than 24 hours

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What are the 4P components of labor?

Passageway
Passenger
Powers
Psyche

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Maternal bony pelvis and vagina as well as cervical tissues. Route that the fetus must travel to deliver.

Passageway

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The fetus

Passenger

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primary and secondary forces of labor (contractions as well as pushing)

Powers

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Psychological components of mother; goal is for the parents to have a positive experience

lots of time is spent here

Psyche

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what must be of adequate size in order to vaginally deliver a baby?

pelvis

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safe labor and delivery depends on (2)

the structure of the fetal head

alignment w the pelvis

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4 methods to determine fetal position, presentation and lie

abdominal inspection and palpation (Leopolds)
vaginal exam
auscultation of FHT
ultrasounds

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what 5 bones of the fetus’s head is most important?

2 frontal, 2 parietal, occipital

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what suture of the fetus’s head is most important?

sagittal suture

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membranous tissue between bones of the skull

sutures

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what occurs when sutures overlap during labor

occurs because of the pressure of the cervix

molding

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how long does molding usually occur?

1-2 days

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____ are junctions of the main suture lines

fontanelles

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what shape is the anterior fontanelle

large and diamond shaped

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what shape is the posterior fontanelle

small and triangular shaped

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when doing a cervical check on a mom, what fontanelle do we want to feel?

Anterior fontanelle (diamond shaped)

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what is the goal of the fetal presenting part?

present the smallest part of the skull to the smallest part of the pelvis

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what occurs when an inappropriate presentation of the fetal head occurs?

It can stall, prolong, or stop labor. Won’t allow for engagement

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Relationship of the long axis of the fetal body to long axis of the mothers body

Fetal Lie

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If a fetus is lying in a mothers abdomen in a horizontal manner, what lie position is this called?

Transverse

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Fetal body part that will first contact the cervix or be born first and determined by the combination of fetal lie and degree of fetal flexion (Attitude)

Fetal presentation

What are three fetal presentations that can occur

Cephalic (Occiput) Breech (Sacrum present) Shoulder (scapula or acromion process)

if the fetal presentation is the fetus's shoulder, what are some things we know right away?

fetus is in a transverse lie can be caused by placenta previa

The relationship of the presenting part to the specific quadrant and size of the pregnant mom's pelvis

Fetal position

position of presenting part toward one of the 4 quadrants of mom's pelvis right anterior left anterior right posterior left posterior

maternal landmarks

If the fetal presenting part is the occiput, what is the letter abbreviation?

If the fetal presenting part is the chin, what is the letter abbreviation?

M (Mentum)

If the fetal presenting part is the sacrum, what is the letter abbreviation?

If the fetal presenting part is the shoulder(scapula or acromion process) , what is the letter abbreviation?

what is the first letter in a fetal position abbreviation meaning?

part of the maternal pelvis the presenting part is toward (R= right, L= Left)

what is the second letter in a fetal position abbreviation meaning?

landmark of the fetal presenting part (O,Sa, M, F, A)

what is the third letter in a fetal position abbreviation meaning?

location of the presenting part a= anterior p= posterior t= transverse

what are the 2 best fetal positions?

LOA or ROA

settling of fetal presenting part into the pelvis

engagement

if a fetus is not engaged, what is it considered and what is the station score?

Considered "Floating" and a score of -4

relationship of presenting part to the ischial spines

Station

describe the station scores of -4, 0, and +4

-4 floating 0 engaged +4 at outlet (Crowning)

to present the smallest diameter of fetal head to the smallest part of the birth canal

cardinal movements

movement of the fetal head in the pelvic inlet and beyond the dilated cervix: pressure from the head on sacral nerve causes need to push

decent

as head reaches the pelvic floor flexes forward

flexion

head enters pelvis during decent in diagonal position. The head then rotates until the occiput is anterior – shoulders are now in correct position

internal rotation

as occiput is born the neck stops beneath the pubic arch – acts as a pivot

extension

immediately after head is born, head rotates back to diagonal – aligns shoulders with outlet

external rotation

if baby is face ___ during delivery birth may be more painful and traumatic

face up

It is typical for a woman to complain of back labor when the fetus is in the ____ position

posterior

in order for uterine contractions to be effective, what do they need to be?

increase in length and intensity as well as they should be rhythmic

what is a primary power?

uterine contractions

what is a secondary power?

maternal pushing efforts

at what point can a laboring woman bear down?

when cervix is fully dilated

if a laboring woman bears down before she is fully dilated what can occur?

fetal and cervical damage

what are false contractions called

braxton hicks

looking at a uterine contraction strip: length of contraction

duration

looking at a uterine contraction strip: from onset of one contraction to onset of the next

frequency

looking at a uterine contraction strip: strength of contraction

intensity

shortening and thinning of cervical canal (0-100%)

effacement

how does effacement occur?

contractions

_____: enlargement or widening of the cervical canal (0- 10 cm) * ____ occurs due to contractions and pressure on the cervix

dilation

psychological state or feeling tat women bring to labor - emotional status - expectations -complications of pregnancy -previous childbirth experience -support?

psyche

first stage of labor has how many stages?

first stage of labor: when cervical dilation is 0-5cm

latent phase

first stage of labor: when cervical dilation is 6-7cm

active phase

first stage of labor: when cervical dilation is 8-10cm

Transition Phase

this stage of labor begins w complete cervical dilation and ends w birth of infant

second stage of labor

stage of labor begins with birth of infant and ends with expulsion of placenta

third stage of labor

stage of labor is the first 1-4 hours after birth of the placenta

fourth stage of labor

approximately how long does stage 1 of labor last?

around 12 hours

pain control used in the first stage of labor

distraction aromatherapy (essential oils) acupressure walking

during the active phase of labor how often should they dilate and by how many cm?

1 cm per hour

approximately how long is the active phase of labor in stage one?

2-3 hours

what what stage and phase are contractions at peak intensity occurring every 2-3 minutes and lasting 60-70 seconds

first stage, transitional phase

at the end of transitional phase what urge occurs?

urge to push

what is it called with the fetus descends into the birth canal?

crowning

what phase is it when the laboring woman starts to push

second stage

the placental stage is what stage of labor?

Third stage

approximately how many ml of blood is typically lost w childbirth?

300 - 500 ml of blood

what are some danger signs of labor for the mother?

- high or low BP - abnormal pulse - prolonged or inadequate contractions - abnormal appearance of abdomen

danger signs in labor for fetus examples

- high or low FHR - meconium staining (Distress) -hyperactivity -low O2 saturation

what are 4 ways to determine fetal positioning and lie?

fetal heart tones Leopold maneuver vaginal exam sonography, if needed

ELECTRONIC MONITORING OF FETAL HEART RATE No amplitude range detected: indicates the natural pacemaker activity of the fetal heart (sympathetic and parasympathetic) may be affected. Narcotics and magnesium may cause.

absent

ELECTRONIC MONITORING OF FETAL HEART RATE Amplitude range is detectable but is 5 beats per minute or fewer

minimal

ELECTRONIC MONITORING OF FETAL HEART RATE Amplitude range is 6-25 beats per minute (normal)

moderate

ELECTRONIC MONITORING OF FETAL HEART RATE Amplitude range is greater than 25 beats per minute-may represent an increased sympathetic response in the neonate due to a stressful intrapartum event

marked

normal fetal heart rate

110 - 160 bpm

- The difference between the highest and lowest heart rate * Most reliable indicators of fetal well-being

variability

4 types of decelerations

Early Decelerations * Late Decelerations * Prolonged Deceleration * Variable Decelerations

Increase in fetal heart rate by 15 beats and last 15 seconds above the baseline

accelerations

Decrease in fetal heart rate

Decelerations

Healthy Pregnancy and Labor Flashcards

(91 cards)