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Flashcards in Intrapartal Care Deck (51):
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Labor

Rhythmic contraction and relaxation of the uterine muscles with the progressive effacement and dilation of cervix leading to the birth of the child

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Reasons for Onset of labor

Hormonal stimulation- prostaglandin, relaxin, oxytocin
Estrogen/progesterone hormone balance shift
Uterine distention

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Prostaglandin

Produced by fetal membranes during pregnancy that can stimulate the uterus to contract

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Relaxin

Produced by placenta, decreased supply can irritate uterus

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Oxytocin

Primary hormone that imitates labor

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Signs of oncoming labor

Lightening
Braxton hicks contractions more pronounced
Cervical changes
Bloody show
Rupture of membranes

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Lightening

Decent of fetal head into pelvis, may occur 2-3 weeks before labor for first time mothers

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Five Ps of labor

Powers
Pelvis/passageway
Passenger
Position of mother
Psyche of mother

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Powers

Contraction of laboratory

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3 phases of contraction

1 increment
2 acme or peak
3 decrement

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What changes about contractions with the stage of labor?

Frequency (beginning of first to the next increment)
Duration
Intensity

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Effacement

Shortening and thinning of the internal cervical os so that it becomes part of the lower uterine segment

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Types of pelvis

Gynecoid, android, anthropoid, platypelloid

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Shape of gynecoid pelvis

Round, most common

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Shape or android pelvis

Heart shaped

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Shape of anthropoid pelvis

Oval

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Shape or platypelloid pelvis

Flat

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What areas does the doctor look at for childbirth on the pelvis

Inlet, outlet, cavity

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Fetal head is most important aspect because

Largest and least yielding of the body

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Sagital suture

Follows a-p line of skull

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Frontal suture

Continuation of sagital suture

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Coronal suture

Between parietal and frontal bones

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Lambdoid suture

Between occipital and parietal bones

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Measurements of fetal skull

Biparietal, suboccipitobregmatic, occipitofrontal, occipitomental

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Molding of fetus head

Overlapping of bones of fetal head that occurs during labor by accommodation of head through birth canal

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Fetopelvic relationship

How fetus is aligned to be birthed

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Lie position

Back bones aligned

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Transverse alignment

Shoulder is presenting, usually from fatigued uterus

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Attitude of fetal body

Flexion (chin to chest, fetal position)
Extension (opposite of flexion)

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Presentations of fetus

Vertex- head first
Shoulder- transverse lie (usually need c section)
Breech- butt or feet coming out first

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Describing fetal position

Left or right side of pelvis
Occipi, mentum, sacrum, scapula (presenting part)
Anterior or posterior (facing mother or away from mother)

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Station measurement of fetal decent

Presenting part of head

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Station stage -3

Floating; above true pelvis

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Station stage -1

Dipping; presenting part is still in pelvis but not engaged

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Station stage 0

Engagement- level of maternal ischial spines

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Station stage +3/4

Crowning

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Positions of mother for birth

Sitting up is best, side lying works well, walking for first stages

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Psychological response of mother

Affected by tension and fear, helps being prepared and Aware,

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Mechanisms of labor

Accommodation of fetal anatomy to the maternal pelvis and birth canal and passage of fetus from uterus to outside world

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Engagement decent Mechanisms of labor

Presenting part enters true uterus

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Mechanisms of labor- decent

Presenting part at ischial spines

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Mechanisms of labor- flexion

When fetal head meets resistance from pelvis flexion of head is necessary

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Mechanisms of labor- internal rotation

Caused by 3 factors- pressure from contractions, curved shape of pelvis, and relationship of vertex

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Mechanisms of labor- extension

From pressure of uterus

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Mechanisms of labor- restitution

Head rotates 45 degrees a After birth of the head

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Mechanisms of labor- external rotation

Occurs as shoulders rotate 45 degrees

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Mechanisms of labor- expulsion

Birth of shoulders

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First stage of labor

Longest- onset to 10cm dilation

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Second stage of labor

From full dilation to birth of baby

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Third stage of labor

Birth of baby to birth of placenta

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Fourth stage of labor

Two afters after placenta is delivered