Intrapartum 1 Flashcards by maria ru

Refers to a series of events by which uterine contractions & abdominal pressure expel a fetus & placenta from the uterus

labor

How well did you know this?

Not at all

Perfectly

normal labor

eutocia

How well did you know this?

Not at all

Perfectly

as the time from the delivery of placenta through the first week’s after the delivery

puerperium

How well did you know this?

Not at all

Perfectly

a woman about to give birth

parturient

How well did you know this?

Not at all

Perfectly

what trigger the random, painless, braxton hick contraction into strong, corrdinated, productive labor

unknown

How well did you know this?

Not at all

Perfectly

uterus stretches with the baby to the maximum and this causes the uterine muscles to start contracting so that the uterus regains its normal size and shape

Uterine stretch theory

How well did you know this?

Not at all

Perfectly

Pressure on the cervix stimulates the release of oxytocin from the posterior pituitary gland causing uterine contractions

Oxytocin Theory

How well did you know this?

Not at all

Perfectly

suggests that labor begins when progesterone levels in the body decrease and this usually happens towards the end of pregnancy

Progesterone Deprivation Theory

How well did you know this?

Not at all

Perfectly

the placenta begins to age and these results in insufficient nutrients reaching the fetus leading to labor

Aging Placenta Theory

How well did you know this?

Not at all

Perfectly

-Latter part of pregnancy
-secreted from the fetal membrane.
-A decrease in progesterone amount also elevates the prostaglandin level.
-Synthesis of prostaglandin causes uterine contraction, labor is initiated

Prostaglandin Theory

How well did you know this?

Not at all

Perfectly

the route a fetus must travel from the uterus through the cervix & vagina to the
external perineum and must be of adequate size

passage

How well did you know this?

Not at all

Perfectly

Two pelvic measurements important to determine the adequacy of the pelvic size

diagonal conjugate, the AP diameter of the inlet

transverse diameter of the outlet

How well did you know this?

Not at all

Perfectly

critical factors in the passage

ability of the cervix to __________ and__________

ability of the vaginal
canal and the introitus to ________

dilate & efface

distend

How well did you know this?

Not at all

Perfectly

movement of the fetus, through the birth canal is determined by several interacting factors

the fetal head
fetal attitude
fetal lie
fetal presentation
fetal position

How well did you know this?

Not at all

Perfectly

the most important part of the fetus

fetal head

How well did you know this?

Not at all

Perfectly

fetal head:

It is the ___________ part of the fetus

It is the most ______________ presenting part

It is the ___________ compressible of all parts

largest, frequent, least

How well did you know this?

Not at all

Perfectly

fetal head is compose of how many bones?

7 bones

How well did you know this?

Not at all

Perfectly

spaces between cranial bones

Sutures

How well did you know this?

Not at all

Perfectly

between 2 frontal
bones

frontal suture

How well did you know this?

Not at all

Perfectly

between frontal &
parietal bones

coronal suture

How well did you know this?

Not at all

Perfectly

between 2 parietal bones (midline suture)

sagittal suture

How well did you know this?

Not at all

Perfectly

most important suture overrides in labor (molding) decreasing biparietal diameter by 0.5 to 1 cm

sagittal suture

How well did you know this?

Not at all

Perfectly

posterior suture; between parietal & occipital bones

Lambdoidal

How well did you know this?

Not at all

Perfectly

Membrane-filled spaces called ________________ are located where the sutures intersect

fontanels/fontanelles

How well did you know this?

Not at all

Perfectly

triangular in shape, junction of parietal & occipital bones; closes at 2- 3 months, as early as 2 months & as late as 4 months

Posterior fontanelle(LAMBDA)

diamond- shaped “soft spot” in front of the head, junction between frontal & parietal bones, closes at 18 months

Anterior fontanelle (BREGMA)

what are the four fontanelles

anterior fontanelle posterior fontanelle sphenoidal fontanelle mastoid fontanelle

Mentum

fetal chin

Sinciput

upper part of the skull, especially the anterior portion above and including the forehead

Bregma

large diamond-shaped anterior fontanelle

Vertex

area between the anterior and posterior fontanels

Occiput

area of the fetal skull occupied by occipital bone

9.25 cm: biggest transverse diameter

biparietal

9.5 cm- smallest AP diameter

Suboccipitobregmatic

Indication that a baby is hungry

sunken fontanel of baby

when oxytoxin is given? and why?

after birth to keep the uterus contracted

Normal female pelvis Most favorable for successful labor and birth inlet is round and wide

gynecoid

Refers to the flat female pelvis Less favorable for vaginal delivery due to shape Inlet is transverse oval 5%

Platypelloid pelvis

Resembles a male pelvis, and common for tall women. May lead arrest of labor in vaginal delivery due to shape. inlet is heart shaped 20%

android pelvis

Ideal and large enough passage for vaginal delivery Inlet is oval 25%

anthropoid

Baby’s head changes shape to pass through the birth canal during a vaginal delivery

molding

Transverse diameters Biparietal: _____ cm bitemporal:_____ cm Bi mastoid:_____ cm

9.25 8 7

Antero-posterior diameters occipitomental :______cm occipitofrontal: _______ cm suboccipitobreagmatic: ______ cm

13.5 11-12 9.5

AP are more _________ than transverse diameters.

wider

relation of the fetal body parts to each other

fetal attitude/habitus

head flexed on chest

flexion

head extended, occiput touches the back

Extension

normal and good attitude in cephalic presentation. The fetal neck is fully flexed, with the chin touching the chest. Occiput presenting part

complete flexion

Military or partially flexed This position may be less favorable than complete flexion Vertex presenting part

moderate flexion

space between anterior and posterior fontanelle

vertex

Fetal head extends backwards May complicate delivery leading to potential issues

Forehead presenting part

Fetal head is extended backward significantly The least favorable position for delivery. Swollen face

face/brow presenting part

Relation of the long axis (spinal column) of the fetus to the long axis (spinal column) of the mother

fetal lie

cephalic or breech

Longitudinal/Vertical Lie

presenting part is the shoulder

Transverse/Horizontal Lie

Unstable & always become longitudinal or transverse during labor

oblique lie

The body part of the fetus that enters the pelvic inlet first & leads through the birth canal during labor

fetal presentation

Fetal Lie Degree of Fetal Flexion (Attitude)

fetal presentation

most frequent type or presentation

cephalic

A normal condition in newborns where there is localized swelling (edema) on the scalp due to pressure during delivery

Caput succedaneum

Knees & Hips flexed, thighs on abdomen & calves on posterior thighs, buttocks & feet present

complete breech

Hips flexed & knees extended, buttocks present

frank breech

Hips & legs extended, with one foot present

Single footling

Hips & legs extended, w/ both feet present

double footling

Completely covering the cervix, it can bleed easily, tendency for the baby to be transversed relaxed abdomen

placenta previa

Breech and shoulder presentations are associated with difficulties during labor, and labor does not proceed as expected; therefore, they are called _____________________

malpresentations

what is the landmark of vertex presentation

occiput

what is the landmark of face presentation

mentum

what is the landmark for breech presentation

sacrum

what is the landmark for shoulder presentation

acromion process

Defines whether the landmark is pointing To the mother’s right R or L

first letter

it denotes the fetal landmarks O: For occiput M: For Mentum or chin S: Sacrum A: Acromion Process

middle letter

denotes whether the landmark points A: Anteriorly P: Posteriorly T: Transversely

last letter

recommended fetal position

LOA

Relationship of presenting part of the level of the ischial spine (IS) Measure of the degree of descent of the presenting part of the fetus through the birth canal.

station

above ischial spine ___ station

Minus(-)

below ischial spine ____ station

plus(+)

baby’s head becomes visible and remains at the vaginal opening during contractions

crowning

on what station when crowing occurs

occurs when the sagittal suture is midway between the symphysis pubis and the sacral promontory

synclitism

occurs when the sagittal suture is directed toward either the symphysis pubis or the sacral promontory and feels misaligned

asynclitism

presenting part above the inlet, in false pelvis

Floating(-3)

presenting part at pelvic outlet

Station (+5)

-2 station

dipping

presenting part below the inlet, in true pelvis, no longer moving but not yet engaged

Fixed(-1)

presenting part at pelvic inlet

Station (-5)

presenting part at IS

Engaged /Station O

Involuntary & voluntary powers combine to expel the fetus, the fetal membranes & the placenta from the uterus

powers of labor

primary power/force

involuntary

Secondary power/force

Voluntary, Maternal push with uterine contractions

force responsible for the effacement & dilation of the cervix and descent of the fetus rhythmic but intermittent

primary

line of demarcation between the upper and lower uterine segment present during normal labor and cannot usually be felt abdominally

physiologic retraction ring

rising up retraction ring during obstructed labor due to marked retraction, the shape of abdomen in obstructed labor thickening of the upper uterine segment while the relatively passive lower segment is markedly stretched and thinned to accommodate the fetus

BANDL'S RING

how many phases in each contraction?

what are the phases of each contraction

increment acme decrement

The longest phase where the contraction gradually builds up. The intensity increases steadily until it reaches its peak.

increment

The peak of the contraction, representing the maximum intensity of the contraction

acme

The phase where the intensity of the contraction decreases after reaching the acme

decrement

Beginning to end of one contraction

duration

Beginning of one contraction to the beginning of the next contraction. e.g. contractions comes every 5 min and last 60 seconds.

frequency

Fundus indents easily Feels like a tip of your nose

mild intensity

Fundus indents less easily Firm fundus that is difficult to indent Feels like a chin

moderate intensity

* Fundus cannot be indented Feels like a forehead

strong intensity

Contractions occurring more often than every two minutes & persistent contraction duration not longer 70 seconds may reduce fetal _____________ supply and should be reported

oxygen

Shortening & thinning of the cervix during the first stage of labor

effacement

Enlargement or widening of the cervical opening & the cervical canal that occurs once labor has begun

dilation/ dilatation

Use of abdominal muscles to push during the second stage of labor. The voluntary bearing down efforts by the woman.

secondary power

it can cause cervical edema (which retards dilatation), possible tearing and bruising of the cervix, and maternal exhaustion If the cervix is not ______________ when bearing down

fully dilated

position that may help stimulate effective contractions all use gravity to help baby's descent

walking, standing, leaning

position that relieve back pain help rotate the baby in the most favorable position relieves hemorrhoids

kneeling

position the uses gravity to help baby descent allow rest between contraction

sitting

position that uses gravity to help baby descent opens pelvis to provide more room

squatting

Woman must be relaxed, aware & participating in the birth process to result for _________ and ____________ labor

shorter and less