Labor and Delivery Flashcards
1
Q
- 0 to 4-6cm
- contractions may go away
- no need for cesarean or intervention if not dilating (unless other indication)
- avoid admission to hospital at this stage
- may take a long time
A
Early labor
2
Q
- 4-6cm
- 6 hours is normal to go from 4-5cm
- more than 3 hours is normal to go from 5-6 cm
- patience is indicated during this stage of labor
- interventions such as (AROM) may cause more harm
A
transition from early to active labor
3
Q
- 6-10 cm
- faster dilation in multiparous women that primps
- interventions such as rupture of membranse or pictocin may be indicated if slow dilation
- Cesarean may be indicated for failure to progress if no cervical dilation with 4 hours of adequate contractions or 6 hours of oxytocin without adequate contractions
A
Active first stage of labor
4
Q
- pushing stage
- from complete dilation of cervix to delivery of the baby
- the fetal head comes below the maternal pelvic bone and then extends
- ok to “labor down” breathe through contraction even after completely dilated; does not lower cesarean or assisted vaginal delivery rates
- may try many positions including back, side, hands and knees, standing, squatting birthing ball
A
Second Stage of labor (delivery of the baby)
5
Q
- from delivery of baby to delivery of placenta
- active management means gentle traction on cord and pictocin with delivery of the anterior shoulder and has been associated with less blood loss, shorter delivery of the placenta and fewer cases of retained placenta
A
third stage of labor
6
Q
Cephalic or vertex?
A
baby’s head is down
7
Q
What does LOA in relation to position mean?
Left occuiput anterior
A
- means the occiput (back) of the baby’s head is anterior and left in relation to the maternal pelvis and the head is facing down
8
Q
what does ROP mean in relation to the position?
Right occiput posterior
A
the baby is facing up and to the mom’s left
9
Q
- self administered
- study rate as less effective than IV sedation
A
nitrous oxide
10
Q
if given too close to delivery can cause respiratory distress of newborn
A
anesthesia
11
Q
- takes pain away completely
- slows labor
- higher rate of vacuum and forceps assisted deliveries
- no difference in cesarean rate
- higher rate of fever(dx chorio, antibiotics, baby in NICU)
- higher rate of occiput posterior position
A
epidural
12
Q
- routinely performed in the past
- rarely indicated today
A
episiotomy
13
Q
- fewer 3rd and 4th degree lacerations
- more blood loss
- more difficult repair
- more pain
- most common outside US
A
Medial lateral episiotomy
14
Q
- Easier repair
- less pain
- less bleeding
- more 3rd and 4th degree extentions
- most common in the US
A
Midline episotomy
15
Q
what are the 4 ps of labor dystocia?
A
- Passenger- baby too big
- passage- pelvis too small
- presentation- head may be anaclitic or occiput posterior
- power- can only be measured by internal monitors
