Week 7

Question 1

Labor normally begins when a fetus is ———to cope with extrauterine life yet not too large to cause __________with birth.

Answer 1

sufficiently mature

mechanical difficulty

Question 2

results in release of prostaglandins

Answer 2

Uterine muscle stretching

Question 3

which stimulates the release of oxytocin from the posterior pituitary

Answer 3

Pressure on the cervix

Question 4

which works together with prostaglandins to initiate contractions

Answer 4

Oxytocin stimulation

Question 5

(increasing estrogen in relation to progesterone, which is interpreted as progesterone withdrawal)

Answer 5

Change in the ratio of estrogen to progesterone

Question 6

which triggers contractions at a set point

Answer 6

Placental age,

Question 7

which reduces progesterone formation and increases prostaglandin formation

Answer 7

Rising fetal cortisol levels,

Question 8

which stimulates contraction

Answer 8

Fetal membrane production of prostaglandin

Question 9

woman often experiences subtle signs that signal labor is imminent. It is important to review these with women during the last trimester of pregnancy so they can more easily recognize beginning signs.

Answer 9

PRELIMINARY SIGNS OF LABOR

Question 10

lightening, or descent of the fetal presenting part into the pelvis, occurs approximately 10 to 14 days before labor begins.

Answer 10

primiparas

Question 11

related to an increase in epinephrine release initiated by a decrease in progesterone produced by the placenta. This additional epinephrine prepares a woman’s body for the work of labor ahead.

Answer 11

Increase in Level of Activity

Question 12

As___________ level falls, body fluid is more easily excreted from the body. This increase in urine production can lead to a weight loss between 1 and 3 pounds.

Answer 12

progesterone

Question 13

the cervix becomes still softer (described as “butter-soft”), and it tips forward.

Answer 13

Ripening of the cervix

Question 14

an internal announcement that labor is very close at hand.

Answer 14

Ripening of the cervix

Question 15

Signs of true labor involve_____ and______ changes.

Answer 15

uterine

cervical

Question 16

The surest sign that labor has begun

involuntary and come without warning, their intensity can be frightening in early labor

Answer 16

Uterine Contraction

Question 17

Helping a woman appreciate that she can predict when her next one will occur and therefore can control the degree of discomfort she feels by using ____________________offers her a sense of well-being.

Answer 17

breathing exercises

Question 18

As the cervix softens and ripens, the mucus plug that filled the cervical canal during pregnancy(operculum) is expelled.

Answer 18

Show

Question 19

This blood, mixed with mucus, takes on a pink tinge and is referred to as

Answer 19

show or bloody show.

Question 20

Labor may begin with_____________________, experienced either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina.

Answer 20

rupture of the membranes

Question 21

Two risks associated with ruptured membranes are

which could cut off the oxygen supply to the fetus

Answer 21

intrauterine infection and prolapse of the umbilical cord

Question 22

successful labor depends on four integrated concepts:

Answer 22

Passage
Passenger
Power
Psychological

Question 23

the passage

Answer 23

woman’s pelvis

Question 24

passenger

Answer 24

fetus

Question 25

The powers of labor

Answer 25

uterine factors

Question 26

psychological outlook

Answer 26

positive experience.

Question 27

refers to the route a fetus must travel from the uterus through the cervix and vagina to the external perineum.

Answer 27

passage

Question 28

Two pelvic measurements are important to determine the adequacy of the pelvic size:

Answer 28

diagonal conjugate transverse diameter

Question 29

part least likely to be able to pass through the pelvic ring.

Answer 29

head

Question 30

change in the shape of the fetal skull produced by the force of uterine contractions pressing the vertex of the head against the not-yet-dilated cervix.

Answer 30

Molding

Question 31

refers to the settling of the presenting part of a fetus far enough into the pelvis to be at the level of the ischial spines, a midpoint of the pelvis.

Answer 31

Engagement

Question 32

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

Answer 32

Station

Question 33

When the presenting fetal part is at the level of the___ spines, it is at a 0 station

Answer 33

ischial

Question 34

If the presenting part is above the spines, the distance is measured and described as_________ stations, which range from 1 to 4 cm.

Answer 34

minus

Question 35

If the presenting part is below the ischial spines, the distance is stated as______ stations (+1 to +4)

Answer 35

plus

Question 36

describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other

Answer 36

Fetal Attitude

Question 37

A fetus in good attitude is in(1): the spinal column is bowed (2) , the head is flexed forward so much that the chin touches the(3) , the arms are flexed and folded on the chest, the thighs are flexed onto the abdomen, and the calves are pressed against the (4) aspect of the thighs.

Answer 37

1. complete flexion 2. forward 3. sternum 4. posterior

Question 38

This normal “fetal position” is advantageous for birth because it helps a fetus present the smallest anteroposterior diameter of the skull to the pelvis and also because it puts the whole body into an____________ shape, occupying the smallest space possible.

Answer 38

ovoid

Question 39

A fetus is in moderate flexion if the chin is not touching the chest but is in an alert

Answer 39

military position”.

Question 40

means that the widest part of the fetus (the biparietal diameter in a cephalic presentation; the intertrochanteric diameter in a breech presentation) has passed through the pelvis inlet or the pelvic inlet has been proved adequate for birth.

Answer 40

Descent

Question 41

the relationship between the long (cephalocaudal) axis of the fetal body and the long (cephalocaudal) axis of a woman’s body; in other words, whether the fetus is lying in a horizontal (transverse) or a vertical (longitudinal) position

Answer 41

Fetal Lie

Question 42

the most frequent type of presentation, occurring as often as 95% of the time. With this type of presentation, the fetal head is the body part that will first contact the cervix

Answer 42

Cephalic Presentation

Question 43

The four types of cephalic presentation

Answer 43

vertex, brow, face, and mentum

Question 44

The four types of cephalic presentation

Answer 44

vertex, brow, face, and mentum

Question 45

means that either the buttocks or the feet are the first body parts that will contact the cervix occur in approximately 3% of births and are affected by fetal attitude.

Answer 45

Breech Presentation

Question 46

Three types of breech presentation

Answer 46

complete, frank, and footling

Question 47

In a transverse lie, a fetus lies horizontally in the pelvis so that the longest fetal axis is perpendicular to that of the mother.

Answer 47

Shoulder Presentation

Question 48

Leg folded with feet at the level of the baby’s bottom

Answer 48

Complete breech

Question 49

One or both feet point down so the legs would emerge first

Answer 49

Footling breech

Question 50

Legs point up with feet by the baby’s head so the bottom emerges first

Answer 50

Frank breech

Question 51

Position is the relationship of the presenting part to a specific quadrant of a woman’s pelvis.

Answer 51

FETAL POSITION

Question 52

Passage of a fetus through the birth canal involves several different position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the pelvis.

Answer 52

MECHANISM OF LABOR

Question 53

Passage of a fetus through the birth canal involves several different position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the pelvis.

Answer 53

MECHANISM OF LABOR

Question 54

These position changes are termed the cardinal movements of labor:

Answer 54

descent, flexion, internal rotation, extension, external rotation, and expulsion.

Question 55

the downward movement of the biparietal diameter of the fetal head to within the pelvic inlet. occurs when the fetal head extrudes beyond the dilated cervix and touches the posterior vaginal floor. occurs because of pressure on the fetus by the uterine fundus. The pressure of the fetal head on the sacral nerves at the pelvic floor causes the mother to experience a pushing sensation. may be aided by abdominal muscle contraction as the woman pushes.

Answer 55

Descent

Question 56

As descent occurs and the fetal head reaches the pelvic floor, the head bends forward onto the chest, making the smallest anteroposterior diameter (the suboccipitobregmatic diameter) present to the birth canal.

Answer 56

Flexion

Question 57

During descent, the head enters the pelvis with the fetal anteroposterior head diameter (suboccipitobregmatic, occipitomental, or occipitofrontal, depending on the amount of flexion) in a diagonal or transverse position. The head flexes as it touches the pelvic floor, and the occiput rotates to bring the head into the best relationship to the outlet of the pelvis (the anteroposterior diameter is now in the anteroposterior plane of the pelvis). This movement brings the shoulders, coming next, into the optimal position to enter the inlet, putting the widest diameter of the shoulders,

Answer 57

Internal Rotation

Question 58

As the occiput is born, the back of the neck stops beneath the pubic arch and acts as a pivot for the rest of the head.

Answer 58

Extension

Question 59

almost immediately after the head of the infant is born, the head rotates (from the anteroposterior position it is assumed to enter the outlet) back to the diagonal or transverse position of the early part of labor. This brings the aftercoming shoulders into an anteroposterior position, which is best for entering the outlet. The anterior shoulder is born first, assisted perhaps by downward flexion of the infant’s head.

Answer 59

External Rotation

Question 60

Once the shoulders are born, the rest of the baby is born easily and smoothly because of its smaller size. This movement,

Answer 60

Expulsion

Question 61

This is the force supplied by the fundus of the uterus, implemented by uterine contractions, a natural process that causes cervical dilatation and then expulsion of the fetus from the uterus. After full dilatation of the cervix, the primary power is supplemented by use of the abdominal muscles. It is important for women to understand they should not bear down with their abdominal muscles until the cervix is fully dilated. Doing so impedes the primary force and could cause fetal and cervical damage

Answer 61

effective powers of labor

Question 62

A contraction consists of three phases:

Answer 62

increment, when the intensity of the contraction increases; the acme, when the contraction is at its strongest; and the decrement, when the intensity decreases

Question 63

Even more marked than the changes in the body of the uterus are two changes that occur in the cervix: effacement and dilatation

Answer 63

Cervical Changes

Question 64

is shortening and thinning of the cervical canal. Normally, the canal is approximately 1 to 2 cm long. With effacement, the canal virtually disappears.

Answer 64

Effacement

Question 65

refers to the enlargement or widening of the cervical canal from an opening a few millimeters wide to one large enough (approximately 10 cm) to permit passage of a fetus.

Answer 65

Dilatation

Question 66

psychological state or feelings that a woman brings into labor. For many women, this is a feeling of apprehension or fright. For almost everyone, it includes a sense of excitement or awe.

Answer 66

PSYCHE