MCN 2F Flashcards by Labios Ruzell Ray C.

Series of events by which uterine contractions and abdominal pressure expel a fetus and placenta

Labor

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First Stage of Labor

Dilatation

Cervix dilates fully to a diameter of 10cm (2 inches)

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Before 37-42 weeks

Preterm

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Beyond 42 weeks

Post term

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Exact mechanism that triggers onset of labor

Unknown

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Combination of Occurrences as Responsible of Labor

Uterine Stretching

Changes in Estrogen and Progesterone balance

Cervical Pressure

Prostaglandins production by the fetus

Aging of the placenta

Increased Fetal Cortisol Level

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Components of Labor

Passage

Passenger

Power

Psyche

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Passage

Refers to maternal pelvis

Route that the fetus must travel from uterus through the cervix and vagina to the external perineum

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Bony ring formed by four united bones:

2 innominate bones
Coccyx
Sacrum

Support and protect pelvic organs

Pelvis

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Provide stability to the pelvis

Symphysis Pubis

Right Sacroiliac Joint

Left Sacroiliac Joint

Sacrococcygeal Joint

Four Pelvic Joints

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Innominate bones: ilium (upper and lateral), ischium (inferior) and pubis

Hip - crest of ilium

Ischial tuberosities - markers used to determine lower pelvic width

Symphysis pubis

Sacrum - upper posterior

Coccyx - below sacrum

Parts and Functions of the Pelvis

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Located in the superior half of the pelvis

Upper portion of the pelvic inlet

False Pelvis

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Located in the inferior half of the pelvis

Includes pelvic inlet, pelvic outlet, and pelvic cavity

True Pelvis

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Entrance to the true pelvis

also termed as Pelvic brim

Pelvic Inlet

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Inferior portion of the true pelvis

Pelvic outlet

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Space between the inlet and the outlet

Pelvic Cavity

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Imaginary line that separates the true pelvis and the false pelvis

Linea Terminalis

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Ideal type for childbirth

Most common type of pelvis for women

Easy passage of the fetal skull and shoulders

Female pelvis

Has inlet that is well-rounded forward and backward

Has a wide pubic arch

“Child bearing hips “

Coca-cola body

Gynecoid-shaped Pelvis

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Pubic arch forms an acute angle; pelvis extremely narrow

Fetus may have difficulty exiting

could lead to Cesarean/Forceps/Vacuum

Male pelvis

Android-shaped Pelvis

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Transverse diameter is narrow

Anteroposterior diameter of the inlet is larger than usual

Oval with longer anteroposterior diameter

Shaped as a monkey

Anthropoid-shaped Pelvis

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Has a smoothly curved oval inlet, but the anteroposterior diameter is shallow.

Pelvis is super wide and super big that it causes difficulty delivering the baby because of flattened oval shape

obese have flattened pelvis

Platypelloid-shaped Pelvis

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Pelvic Inlet: 11cm

Anteroposterior Diameter

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Pelvic Inlet: 13cm

Transverse Diameter

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Pelvic Inlet: 12cm

Oblique Diameter

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Pelvic Inlet: 11cm

True Conjugate

Pelvic Inlet: 10.5-11cm

Diagonal Conjugate

Pelvic Inlet: 10cm

Obstetric Conjugate

Pelvic Outlet: 11.7cm from sacrum/symphysis pubis to coccyx

Anteroposterior Diameter

Pelvic Outlet: 10cm-13.5cm from left ischial tuberosity to the right side of ischial tuberosity

Transverse/Intertuberous Diameter

Pelvic Outlet: 9cm from this part to the sacral iliac joint

Posterior Sagittal Diameter

Lower segment of the uterus expands to accommodate the intrauterine contents Cervix is drawn up and over the presenting part as it descends Vaginal Canal distends to accommodate passage of fetus Play a role in labor and delivery

Soft Tissues

Refers to the fetus and its ability to move

Passenger

Fetal Features as Passenger

Presentation Attitude Station Lie Position

Very important because this is significant during labor and delivery and is used to check for any disabilities

Fetal Skull

Compressible and made mainly of thin pliable tubular flat bones

Fetal Skull

8 bones of the Fetal Skull

2 fused Frontal Bones 2 Parietal Bones 1 Occipital Bone Anchored to the rigid and incompressible bones at the base of the skull

T/F: you can determine specific condition by the use of suture lines

TRUE

Seams between the bones of the skull

Sutures

Coronal

Frontal and Parietal

Lambdoid

Occipital & Parietal

Sagittal

2 Parietal Bones

Squamous

Parietal & Temporal

Flexible fibrous tissue

Fontanelles

Diamond Shaped

Anterior Fontanelle

Located at the juncture of the frontal and parietal bones

Anterior Fontanelle

Formed by joining 2 Frontal and 2 Parietal

Anterior Fontanelle

Fontanelle that closes about 12 to 18 months

Anterior Fontanelle

Triangular Shaped

Posterior Fontanelle

Formed by the junction of 3 lines

Posterior Fontanelle

Located at the juncture of occipital and parietal bones

Posterior Fontanelle

Fontanelle that closes at 8 to 13 weeks

Posterior Fontanelle

Is membranous but becomes bony at term, denotes the position of the head in relation to maternal pelvis

Posterior Fontanelle

9cm-11cm

Ischial Tuberosity

sphenoid ethmoid 2 temporal bones

other 4 bones of the skull

Fetal Skull: 9.25cm

Biparietal/Transverse Diameter

Fetal Skull: 9.5cm

Suboccipitobregmatic

Fetal Skull: 13.5cm

Occipitomental

Fetal Skull: 12cm

Occipitofrontal

Fetal Skull: 9.5cm

Submentobregmatic

Fetal Skull: 10.5cm

Suboccipito Frontal

Fetal Skull: Smallest Diameter

Biparietal/Transverse

Fetal Skull: smallest AP diameter

Suboccipitobregmatic

Fetal Skull: widest AP diameter

Occipitomental

Fetal head flexes so sharply Chin rest on Chest Smallest AP and Suboccipitobregmatic is present

Full Flexion

Occipitofrontal Diameter presents in the birth canal One who presents during the birth that refers to either the brow

Moderate Flexion

When the head is hyperextended Largest Diameter Occipitomental Diameter presents in the birth canal

Poor Flexion

Overlapping of skull bones

Molding

Pertains to the first baby part that will first contact the cervix or to be born first

Fetal Presentation

Degree of flexion a fetus assumes during labor

Fetal Attitude

Vertex spinal column bowed forward head flexed that the chin touches sternum arms flexed and folded on the chest thighs flexed onto abdomen calves pressed against posterior aspects of thigh

Complete Flexion

Sinciput Military Position Bregma is present

Moderate Flexion

Less or minimal amount of amniotic fluid (oligohydroamnios or oligohydramnios)

Complete/Full Extension

Relationship between the long axis of the fetal body and the long axis of the woman’s body

Fetal Lie

Cephalic (below) or Breach (above) Head is below or head is above

Longitudinal Lie

Shoulder presentation Lie is perpendicular to the mother’s axis

Transverse Lie

Affects the duration and difficulty of labor Affects the method of delivery

Fetal Presentations

Cap goes across the suture lines Boggy edematous swelling of the fetal scalp Usually disappears without treatment No pathological significance Swelling and Edema of the fetal scalp

Caput Succedaneum

Involves bleeding in the specific portion of the head of the baby which is the subgaleal space

Subgaleal Hemorrhage

Bleeding in the Periosteum

Cephalohematoma

Vertex Brow Face Mentum

Cephalic Presentation

Buttock or feet contacts first the cervix Presenting part is the sacrum

Breach Presentation

Complete Frank Footling

Types of Breach Presentation

Flexion, except for legs at knees

Frank Breach

Flexion, except for one leg extended at hip and knee

Single Footling Breach

General Flexion

Complete Flexion

Presenting part is the shoulder, iliac crest, hand and elbow, fetus is lying horizontally

Shoulder Presentation/Transverse

Poyhydroamnios/Polyhydramnios

Causes of Shoulder Presentation

Relationship of the presenting part to the specific quadrant or part and side of woman’s pelvis

Fetal Position

Right Posterior Left Posterior Right Anterior Left Anterior

4 Quadrants of Maternal Pelvis

settling of the presenting part of a fetus far enough into the pelvis that it rests at the level of the ischial spines, the midpoint of the pelvis

Engagement

nonengagement of the head at the beginning of labor

Primipara

engagement may or may not be present at the beginning of labor.

Multipara

presenting part that is not engaged

Floating

one that is descending but has not yet reached the ischial spine

Dipping

relationship of the presenting part of the fetus to the level of the ischial spines.

Fetal Station

Occiput

Vertex

Chin/Mentum

Face

Sacrum

Breach

Acromion Process

Shoulder

Regular contraction Increase intensity when walking felt in lower back bloody show dilatation and effacement fetus usually engaged

True Labor

Irregular contractions Often stop when walking Felt in abdomen above umbilicus no change in cervix fetus is ballotable

False Labor

internal cervical mucus plug

Show

Mixed with blood from ruptured cervical capillaries

Bloody Show

MCN 2F Flashcards

(103 cards)