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parent/child: ch 17
| Question | Answer |
|---|---|
| Preterm labor | Generally diagnosed clinically as regular contractions along with a change in cervical effacement or dilation or both, or presentation with regular uterine contractions & cervical dilation of at least 2 cm that occurs at a preterm gestation |
| Preterm birth | Defined as any birth that occurs between 20 0/7 & 36 6/7 weeks of gestation |
| Preterm birth vs. low birth weight | Preterm birth describes the length of gestation whereas low birth weight describes only weight at the time of birth (2500 grams or less) |
| Intrauterine growth restriction (IUGR) | A condition of inadequate fetal growth not necessarily correlated with initiation of labor |
| Spontaneous preterm birth | Just occurs; occurs following an early initiation of the labor process in the apparent absence of maternal or fetal illness |
| Indicated preterm birth | Induced; iatrogenic because they occur to resolve maternal or fetal risk related to continuing the pregnancy |
| Cervical length | One possible predictor of preterm labor |
| Fetal fibronectin (fFN) | Diagnostic test for preterm labor; fFn is a “glue” found in plasma & produced during fetal life; presence during late 2nd & early 3rd trimesters may be related to placental inflammation -> spontaneous preterm labor; *false positives can occur |
| Tocolytics | Medications given to arrest labor after uterine contractions & cervical change have occurred |
| It’s Not My Time (Tocolytic Meds) | Indomethacin (NSAID) Nifedipine (Calcium channel blocker) Magnesium sulfate (*Depresses CNS) Terbutaline (Adrenergic agonist) |
| Contraindications to Tocolytic Therapy | Mom: preeclampsia & bleeding; baby: fetal demise, lethal anomaly, nonreassuring fetal status, chorioamnionitis, & preterm PROM |
| Antenatal glucocorticoids | Given as IM injections to the mother to accelerate fetal lung maturity by stimulating fetal surfactant production (Betamethasone or Dexamethasone); consideration: assess glucose levels |
| Betamethasone | 12 mg IM for 2 doses 24hrs apart |
| Dexsmethasone | 6 mg IM for 4 doses 12 hrs apart |
| Prelabor rupture of membranes (PROM) | Spontaneous rupture of the amniotic sac & leakage of amniotic fluid before the onset of labor at any gestation age |
| Preterm prelabor rupture of membranes (pPROM) | Membrane rupture before 37 0/7 weeks of gestation |
| pPROM management | Conservative because of risk of infection; daily fetal assessment (NST & biophysical profile) |
| Chorioamnionitis | Bacterial infection of the amniotic cavity |
| Postterm pregnancy | One that reaches 42 0/7 weeks of gestation or more; teaching: assess daily kick counts, signs of labor, contact HCP if in labor or no movement, keep appts & cervical checks, & go to hospital as soon as labor begins; increased stillbirth risk at 41 weeks |
| Dystocia | Refers to lack of progress in labor for any reason |
| Dysfunctional labor | Defined as a long, difficult, or abnormal labor |
| Latent phase disorders | Having painful & frequent contractions that are ineffective in causing cervical dilation or effacement to progress; occurs in first stage labor |
| Active phase disorders | The woman initially makes normal progress into the active phase of first stage labor, but then the contractions become weak & inefficient or stop altogether |
| Abnormal labor patterns | 1) Prolonged latent phase 2) Protracted active phase dilation 3) Secondary arrest: no change 4) Protracted descent 5) Arrest of descent 6) Failure of descent |
| Precipitous labor | Defined as labor that lasts less than 3 hours from the onset of contractions to the time of birth |
| Cephalopelvic disproportion (CPD) | Disproportion between the size of the fetus & the size of the mother’s pelvis |
| Leopold maneuvers | Abdominal palpitations used to diagnose breeched presentation |
| Version | The turning of the fetus from one presentation to another |
| External cephalic version (ECV) | Used to turn the fetus from a breech or shoulder presentation to a vertex presentation for birth |
| Before ECV… | Ultrasound & NST |
| Internal version | The fetus is turned by the HCP, who inserts a hand into the uterus & changes the presentation to cephalic (head) or podalic (foot) |
| Induction of labor | Chemical or mechanical initiation of uterine contractions before their spontaneous onset for the purpose of bringing about birth |
| Elective induction | One in which labor is initiated without a medical indication |
| Bishop score | A rating system to see if the woman is eligible for induction (8 or more on 13-point scale is good) |
| Cervical ripening methods | Chemical agents (prostaglandins: Cytotec & Cervidil), balloon catheters (falls out at 3cm), sexual intercourse, amniotomy (artificial rupture of membranes), & oxytocin |
| Oxytocin | A hormone normally produced by the posterior pituitary gland; complication: uterine tachysystole |
| Uterine tachysystole | More than 5 contractions in 10 minutes, averaged over a 30 minute window |
| Augmentation of labor | Stimulation of uterine contractions after labor has started spontaneously & progress is unsatisfactory |
| Forceps-assisted birth | One in which an instrument with 2 curved blades is used to assist in the birth of the fetal head |
| Vacuum assisted birth | Birth method involving the attachment of a vacuum cup to the fetal head, using negative pressure to assist in the birth of the head |
| Cesarean birth | Birth of a fetus through a transabdominal incision of the uterus (vertical or transverse [bikini]) |
| Elective cesarean birth | Refers to a primary cesarean birth without medical or obstetric indication |
| Trial of labor | Observance of a woman & her fetus for a reasonable period of spontaneous active labor to assess the safety of vaginal birth for the mother & infant (ex: VBAC - vaginal birth after c-section) |
| Meconium-stained amniotic fluid | Indicates that the fetus has passed meconium (first stool) before birth; emergency because of risk of aspiration |
| Shoulder dystocia | Condition in which the head is born, but the fetal shoulders are unable to pass through the maternal pelvis |
| Prolapse of umbilical cord | Occurs when the cord lies below the presenting part of the fetus |
| Uterine dehiscence | Separation of a prior scar |
| Amniotic fluid embolus (AFE) | Complication of pregnancy characterized by the sudden, acute onset of hypoxia, hypotension, & hemorrhage caused by coagulopathy |
| McRoberts | = military; knees to chest position; lying flat; birth in less than 5 min; suprapubic pressure = roll baby |
| Gaskin | = gorilla; hands & knees |
Created by:
tatianalopez03
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