Normal Labor Flashcards by Pawel Parafianowicz

Labor definition

Baby and placenta with umbilical cord are expelled out of the uterus

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Labor definition

Baby and placenta with umbilical cord are expelled out of the uterus

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Components of birthing kit

Surgical scissors or a scalpel
Umbilical cord clamps
A small rubber bulb syringe
Towels
4x4 gauze sponges and/or 2x10 gauze sponges
Sterile gloves
Infant blankets
Sanitary napkins
Infant sized bag-mask device
Goggles
A plastic bag

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When is a due date?

40 weeks from the first day of her last period.

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How is due date determined?

Based on ultrasound and LMP

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When due date is adjusted?

When there is >7d difference in 0-13wk

When there is >10 difference in 14-20wk

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What is term?

Normal timing

37-42

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What is preterm?

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What are contraindication to normal vaginal delivery?

Complete placenta previa (baby cannot get out without life-threatening bleed)
Activeherpes simplex lesion
Previous vertical uterine incision or uterine surgery (risk for rupture)
Malpresentation (breech, transverse)

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Components of birthing kit

Surgical scissors or a scalpel
Umbilical cord clamps
A small rubber bulb syringe
Towels
4x4 gauze sponges and/or 2x10 gauze sponges
Sterile gloves
Infant blankets
Sanitary napkins
Infant sized bag-mask device
Goggles
A plastic bag

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When is a due date?

40 weeks from the first day of her last period.

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How is due date determined?

Based on ultrasound and LMP

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When due date is adjusted?

When there is >7d difference in 0-13wk

When there is >10 difference in 14-20wk

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What is term?

Normal timing

37-42

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What is preterm?

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What are contraindication to normal vaginal delivery?

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Events during onset of labor

Labor is defined as regular, painful, uterine contraction resulting in progressive cervical effacement (thinning) and dilation

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What is the name for contractions that do not dilate cervix

Braxton-Hicks

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What are the signs of labor

Onset of contractions
Bloody show
Leaking fluid (rupture of membranes) (ROM)

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What is the difference between early vs. active labor

will deliver in hours immediate delivery

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What are prime events during
1st stage of labor
2nd stage of labor
3rd stage of labor

Cervix dilation
Delivery of baby
Delivery of placenta

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How much is cervix dilated during 1st stage of labor?

10cm

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What is important to monitor during 1st stage of labor?

Fetal heart beet 110-160 every 5-15min

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What needs to be done if fetal heart rate is lower than 90/m for more than 60-90s?

Study These Flashcards

1) Woman is on her right side
2) Consider administering Lactated Ringer’s or 0.9% saline w/ oxygen 10L/min by non-rebreather mask
3) Considering to a hands and knees position

What starts second stage of labor?

Active maternal pushing efforts

What should be checked as head is pulled out? What can be done?

Nuchal cord | Clamped twice

How to proceed with delivery after getting the head out?

Gentle downward traction with one globed hand on each side of the fetal head

Condition when shoulders are stuck

Shoulder dystocia

What should be done when baby comes out?

Dry it (prevent hypothermia, and stimulate breathing)

Delaying clamping 2-3minbenefit and risk

+increase iron storage | -jaundice

What consists the 3rd stage of labor?

Traction on the cord/placenta Oxytocin 10U IM or 20U/liter NS IV at 250 cc/h (to decrease bleeding)

Purpose of uterine massage

Uterus contract limiting bleeding

What should be done if there is a laceration of the perineum or vagina

Gauze should be applied

What questions should be asked when evaluating pregnant woman?

Length of Gestation/ Due date (fetal viability/prematurity) Gravidity and Parity (previous deliveries, live births, premature births) OBGYN Complications (cesarean or mymectomy) Pregnancy Complications Medical Problems Allergies Medications Habits Prenatal Care

How is due date determined?

From the first date of the woman's last menstrual period

How gestational age can be estimated w/o LMP?

Fundal heights in the 2nd and 3rd trimester or bimanual pelvic exam in 1st trimester

How prenatal care affects weight on infants?

It decrease number of low birth weight infants

What effect on pregnancy does tobacco and other illicit drugs have?

Risk of abruption Preterm labor Small for gestation age

In pregnant woman, what does urge to bear down or having bowel movement may indicate?

Imminent delivery

Vaginal fluid (examples) - normal - infection - gush

- vaginal discharge can be normal - foul smelling - rupture of membranes

Dark & Spotting vs. Red & Heavy bleeding

Dark & Spotting = Benign (e.g. polyp, cervical change) | Heavy bleeding = Uterine rupture, placental abruption

Patterns of blood pressure during pregnancy in pregnant woman

Decrease in 2nd | Come back in 3rd

What is the difference between chronic HTN and preclampsia?

20 wks

What is the difference between severe and mild preclampsia?

160/110

How does pulse of pregnant women is different than normal individual?

Increases 15-20

What is normal temperature for pregnant woman?

Can be 1-2 degree higher | It should not be higher than 100.4 F

What causes increased respiratory rate and tidal volumes during pregnancy?

Progesterone

How fundal height can predict age of the fetus?

Measure pubic symphysis to top of uterus Centimeters estimate weeks Before 20wk hard to palpate At 20wk at pubic symphysis

What is the indication of: Tender uterus Tender adnexa

Uterine infection, rupture, or abruption | Ectopic pregranancy, infection or ovarian cyst

What is the timing and frequency during labor?

45-60 seconds ever 3-5 min

What is placenta previa?

Placenta attachment to the uterus is either covering or close to the cervix

What are symptoms of placenta abruption?

Back pain and vaginal bleeding

What is vasa previa?

Blood vessels of the umbilical cord traverse the amniotic membranes prior entering to the cord

Presentation of vasa previa

No pain to mother Bleeding bright Loss of blood to fetus

Alignments of fetus with respect to the birth canal?

Vertex (head down) Breeech (buttock or feet down) Transverse (sideways)

Purpose of Leopold's maneuver

Determine orientation of fetus

Causes for caridopulmonary arrest associated with pregnancy

Amniotic fluid embolism Preeclampsia Excess of magnesium sulfate Postpartum hemorrhage

How position in pregnancy can affect blood flow?

Uterus can pressure aorta and IVC

Modification for CPR with pregnancy

``` 25-30 degree tilt left lateral Increasing chest wall compression Use cricoid pressure Compression higher on strenum Defibrilaion removal of devices Heimlich maneuver ```

Normal Labor Flashcards

(59 cards)