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Flashcards in Intrapartum Concerns Deck (38):
0

Any deviation from normal progress of labor

Dystocia

1

CTX > 2 min, 5 or more/10 min, frequency every 1 minute

Uterine hyperstimulation

2

Slow progress in the active phase

Hypertonic uterine motility

3

Seen in most android pelvis

Occiput posterior

4

Where is FHT located in posterior occiput?

Located in flank and is slower

5

How do you evaluate for occiput posterior position?

Leopold's maneuvers, abdominal contour, suture lines

6

Occiput posterior effects on contractions

Diminish in frequency and intensity

7

Where is labor felt in occiput posterior?

Back

8

What happens to dilation and descent with occiput posterior?

Dilation slows and descent is delayed

9

What is prolonged with occiput posterior?

Active labor and second stage

10

What can happen to the fetus if they are occiput posterior?

Asphyxia

11

How do you manage occiput posterior?

Manual rotation, forceps delivery, forceps rotation, may extend episiotomy

12

How often does breech presentation occur?

3-4%

13

When is breech most common?

Preterm deliveries

14

What risks are associated with breech presentation?

Prolapsed cord, fetal asphyxia, intercranial hemorrhage, birth injuries

15

What is preferred for delivery of a breech?

C-section

16

Helps prevent entrapment of fetal head in a breech

Wigand Martin maneuver

17

When can you do external version?

36-37 weeks

18

What do you use to confirm external version?

Ultrasound

19

What is the success rate with external version?

58%

20

Any head to body delivery time greater than 60 seconds

Shoulder dystocia

21

Risk factors for shoulder dystocia

A- advanced age
D- diabetes
O- obese
P- postterm or previously large baby
E- excessive weight gain in pregnancy

22

Physician tries to go in vaginally and rotate shoulder

Wood's corkscrew

23

Lift the knees toward the head and apply suprapubic pressure for shoulder dystocia

McRobert's

24

Get on all fours to deliver with shoulder dystocia

Gaskin maneuver

25

Replace the head in the pelvis and deliver via c-section

Zanvanelli maneuver

26

When do you use Zanvanelli maneuver?

After all other efforts are attempted

27

What does the Zanvanelli move require?

Uterine relaxation (terbutaline) and general anesthesia

28

What are cues to shoulder dystocia?

Long transition and long second stage

29

What do you need to document during the labor?

Delivery of the head

30

What management does the nurse do with shoulder dystocia?

Maneuver, postpartum assessment, and notify nursery

31

Damaged or torn nerve due to extreme traction on the infants head

Erb's palsy

32

Cord palpated through intact membranes ahead of the presenting part

Fundic cord prolapse

33

Cord not visible or palpable and cord lies beside the presenting part

Occult cord prolapse

34

Cord is seen or palpated ahead of the presenting part

Complete cord prolapse

35

What are symptoms of cord prolapse?

Severe repetitive variables, bradycardia after SROM or AROM, and prolonged deceleration

36

What can you do to manage cord prolapse?

Disengage presenting part, use gravity, fill bladder, tocolytic, IV fluids, oxygen, anticipate c-section

37

What should you never do with a cord prolapse?

Attempt to push it in and do not cover it with anything wet