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Flashcards in Normal Labor and Delivery - Moulton Deck (21):
1

Labor vs False Labor

Labor - regular uterine contractions that cause progressive cervical dilation

False labor - Irregular contractions, no cervical dilation

2

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

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

Well flexed

Suboccipitobregmatic

3

***Most common pelvis shape

Baby position?

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

OA (occiput anterior)

4

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

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

5

2 pelvis shapes w/ poor prognosis for delivery

Platypelloid (transverse)
Android (OP)

6

Diagonal conjugate



Good value?

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

11.5 cm

7

Measuring pelvic inlet

- Distance between ischial tuberosities (> 8.5)
- Infrapubic arch (> 90)

8

****Fetal lie vs. Fetal presentation

Lie = longitudinal, transverse, or oblique

Presentation = vertex, breech, transverse

9

Fully dilated = ___ cm

10

10

Effacement = what?

Thinning of cervix, reported as % of change in length

11

Station = what?
- Values?

Degree of descent of baby
- Zero = at ischial spines
- (-1) to (-5) = above that
- +1 to +5 = below that

12

***Duration of first stage of labor...
- 1st pregnancy
- 2nd + pregnancy

6-18 hours

2-10 hours

13

***Rate of cervical dilation...
- 1st pregnancy
- 2nd + pregnancy

1.2 cm per hour

1.5 cm per hour

14

***2 types of fetal monitoring


***Uncomplicated vs. complicated?

- Continuous
- Intermittent
- Uncomp. = q30 min 1st stage, q15 min 2nd stage
- Comp. = q15 min 1st stage, q5 min 2nd stage

15

***Durations of 2nd stage...
- 1st vs. 2nd +
- Epidural?

1st = 2 hours
2nd = 1 hour
Epidural = ADD 1 HOUR

16

***7 cardinal movements of labor


How to remember?

- 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

If placenta doesn't come out after 30 minutes...

"Retained placenta" - must go get it

18

***Signs of placental separation

- Gush of blood
- Lengthening of cord
- Fundus rises up
- Fundus becomes globular

19

3 most common causes of postpartum hemorrhage

MOST common one?

- Uterine atony
- Retained placenta
- Unrepaired laceration

ATONY

20

***3 ways to ripen a cervix

- Dinoprostone (PGE2 insert)
- Misoprostol (PGE1)
- Foley bulb catheter (mechanical dilation)

21

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

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