Test 2 - Process of Labor Flashcards
(24 cards)
What are the passenger assessments during labor?
Fetal head Fetal lie Fetal presentation Fetal attitude Fetal position Station
What are the 5 P’s
Passenger fetus and placenta Passageway birth canal Powers (Voluntary/ involuntary UC) Position of the mother Psychologic responses
Are fetal skull bones fused?
No. United by membranous sutures
What is BPD?
What does it measure?
Biparietal diameter
Largest transverse diameter of the head
Body part of fetus that first enters the pelvic inlet
Fetal presentation
3 major presentations:
- Cephalic or Vertex (head)
- Breech (buttocks or feet)
- Shoulder
Most favorable fetal presentation?
Can a shoulder presentation be delivered?
Cephalic
No
Relation of spine of baby to Mom’s spine (long axis)
Fetal Lie
Two types of fetal lie:
Longitudinal or Vertical - spines are parallel as in cephalic or breech
Transverse – baby spine at right angle to Mom (as in shoulder presentation)
Relation of fetal parts to one another
Fetal attitude
3 types of fetal attitude
–General flexion head flexed with arms folded onto chest, legs onto abdomen, back curved in shape of C.
Examiner palpates posterior fontanel
–Extended - presents wider part of skull to inlet.
–Examiner’s finger would palpate the mentum (chin) or brow
To determine fetal position
Identify the presenting part
Identify the maternal quadrant the presenting part is facing
he degree of descent of presenting part above/below ischial spines
Fetal Station
presenting part at ischial spines.
engagement
Most favorable pelvic shape
gynecoid
What are primary powers?
Involuntary uterine contractions which cause effacement and dilation
What are secondary powers
voluntary bearing down
Effacement usually precedes dilation in the ________ woman.
nulliparous
thinning and shortening of cervix
effacement
widening of cervical canal to accommodate head of baby
dilation
maternal urge to bear down:
ferguson reflex
premonitory signs of labor
Braxton Hicks – strong. Lightening Energy increased Ripening of cervix Mucus plug expelled Bloody show
What is the purpose of cardinal movements:
To present the smallest diameter of head
7 movements in vertex presentation
-Engagement – BPD at pelvic inlet
-Descent – measured by station + numbers … lower than ischial spines
-Flexion – head flexes toward chest
-Internal rotation – head rotates to occiput anterior
-Extension – occiput passes under symphysis pubis and head … first the occiput
–External rotation (restitution) – realignment of infant head to back/shoulders (back to original position)
Expulsion (birth) – anterior shoulder under symphysis pubis posterior shoulder and body completely emerges
