Flashcards in labor and delviery Deck (30)
1st day of the last LMP=
stages of labor
cervical stage starts with ____ ends with____
starts with labor ends with dilation of the cervix
expulsion stage requires mom to push and ends with
delivery of baby
begins with delivery of baby ends with delivery of the placenta 5-10 minutes
Cardinal movements of baby during labor
flexion at the neck
Internal rotation neck
extension at the neck
external rotation at the neck
labor that doesn't progress as expected
Protraction (cervix isn't dilating fast or baby isn't descending fast enough) or
arrest (dilatataion and descent stops)
cord prolapse and shoulder dystocia
causes or dystocia power tx:
uterine isn't contracting fast engough
passenger dystocia caused by
passage dystocia caused by
birth canal (true pelvis)
head by the ischial spines
issues with pelvis related to dystocia
pelvic inlet (anterior to posterior of pelvic inlet) (obstetric conjugate)
how do you approximate the obstetric conjugate?
measure the diagonal conjugate transvaginally
finger hits the sacral promontory and pubic symphisis distance
this overestimates distance
ideal pelvic type?
Which pelvic type poses a good amount of issues because of the narrowing of the pubic arch?
arrest of descent
anthropoid is wider where?
front to back.
enter looking forward or back (looking up at the pubic bone)
arrest of descent or persistent occiput posterior
issue with flat/platepelloid
wider side to side and baby can rotate
Cord prolapse types
Which cord prolapse is most common and what is it?
overt prolapse, umbilical cord is descending down through cervix
seen a lot in AROM (induced water breaking)
which breech predisposes to cord prolapse
what do you do if you break the water and you feel a cord prolapse?
keep exam hand in the uterus to hold baby up off the cord
call for help prep for C section
manipulating cord risk of?
shoulders trapped behind pelvis
risk of asphyxia
risks of shoulder dystocia
macrosomia, maternal diabetes, obesity, post term gestation, previous history of macrosomia
head pops back up.....possible shoulder dsytocia
mgmt of shoulder dystrocia
knees up to chest (mcroberts)
deliver posterior arm of the fetus
fracture fetal clavical
NO FUNDUS PRESSURE
brachial plexus injuries ca cause from shoulder dystocia