Normal Labor and Delivery - Moulton Flashcards

1
Q

Labor vs False Labor

A

Labor - regular uterine contractions that cause progressive cervical dilation

False labor - Irregular contractions, no cervical dilation

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2
Q

***Fetal head should be in what position at birth?

***What “axis” is the shortest and associated w/ this?

A

Well flexed

Suboccipitobregmatic

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3
Q

***Most common pelvis shape

Baby position?

A

Gynecoid (50%) - round inlet, wide transverse in middle, wide suprapubic arch

OA (occiput anterior)

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4
Q

Woman, delivering well, baby is occiput posterior. Most likely pelvis shape?

A

Anthropoid (20%) - large A-P axis, long narrow oval shape

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5
Q

2 pelvis shapes w/ poor prognosis for delivery

A

Platypelloid (transverse)

Android (OP)

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6
Q

Diagonal conjugate

Good value?

A

Inferior of pubic symphysis to sacral promentory = close to size of pelvic inlet

11.5 cm

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7
Q

Measuring pelvic inlet

A
  • Distance between ischial tuberosities (> 8.5)

- Infrapubic arch (> 90)

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8
Q

**Fetal lie vs. Fetal presentation

A

Lie = longitudinal, transverse, or oblique

Presentation = vertex, breech, transverse

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9
Q

Fully dilated = ___ cm

A

10

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10
Q

Effacement = what?

A

Thinning of cervix, reported as % of change in length

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11
Q

Station = what?

- Values?

A

Degree of descent of baby

  • Zero = at ischial spines
  • (-1) to (-5) = above that
  • +1 to +5 = below that
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12
Q
  • **Duration of first stage of labor…
    • 1st pregnancy
    • 2nd + pregnancy
A

6-18 hours

2-10 hours

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13
Q
  • **Rate of cervical dilation…
    • 1st pregnancy
    • 2nd + pregnancy
A
  1. 2 cm per hour

1. 5 cm per hour

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14
Q

***2 types of fetal monitoring

***Uncomplicated vs. complicated?

A
  • Continuous
  • Intermittent
    • Uncomp. = q30 min 1st stage, q15 min 2nd stage
    • Comp. = q15 min 1st stage, q5 min 2nd stage
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15
Q
  • **Durations of 2nd stage…
    • 1st vs. 2nd +
    • Epidural?
A
1st = 2 hours
2nd = 1 hour
Epidural = ADD 1 HOUR
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16
Q

***7 cardinal movements of labor

How to remember?

A
  • Engagement (station = 0)
  • Descent
  • Flexion (to get SOB diameter)
  • Internal rotation (to OA/OP)
  • Extension (crowining = +5, then rapid extension to birth)
  • External rotation (back to TV)
  • Expulsion (shoulders)

“Every decent family in England eats eggs”

17
Q

If placenta doesn’t come out after 30 minutes…

A

“Retained placenta” - must go get it

18
Q

***Signs of placental separation

A
  • Gush of blood
  • Lengthening of cord
  • Fundus rises up
  • Fundus becomes globular
19
Q

3 most common causes of postpartum hemorrhage

MOST common one?

A
  • Uterine atony
  • Retained placenta
  • Unrepaired laceration

ATONY

20
Q

***3 ways to ripen a cervix

A
  • Dinoprostone (PGE2 insert)
  • Misoprostol (PGE1)
  • Foley bulb catheter (mechanical dilation)
21
Q

**When can you NOT use Cervidil (Dino) or Cytotec (Miso)?

A

Previous C section