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Labor and Birth
| Question | Answer |
|---|---|
| Labor | The process by which the fetus, placenta, and amniotic membranes are expelled from the uterus |
| What initially causes labor to begin | Is not known, but is thought to be a cascade of events. |
| What contributes to the onset of labor | Changes in maternal hormone levels; stretching of the uterus by the growing fetus; and an interaction between the placenta and the fetal pituitary, hypothalamus, and adrenal glands |
| What are the four P's | Passageway, Passenger, Powers, and Psyche |
| Anterior fontanelle | A diamond-shaped area formed by the intersection of four sutures (frontal, sagittal, and 2 cornoal) |
| Posterior fontanelle | A tiny triangular depression formed by the intersection of 3 sutures (1 sagittal and 2 lambdoid) |
| Molding | Shaping the fetal head by overlapping of the cranial bones to facilitate movement through the birth canal during labor |
| Fetal Attitude | Is the relation of teh fetal parts to one another. |
| Fetal lie | Is the relation of teh longitudinal axis of the fetus to the longitudinal axis of the mother |
| Fetal Presenetation | Is determined by the body part of the fetus that is lowest in the mother's pelvis. |
| Fetal Position | A more specific indication of the fetopelvic relationship, is the relationship of some designated point on the presenting part to the four quadrants of the maternal pelvis |
| What are the notations used to describe the fetal position? | R or L: side of the maternal pelvis; correlates with the R or L side of the woman's bodyO, S, or M: Designated point (landmark) of fetal presenting part: O- occiput, S- sacrum, or M- mentum (face)A or P: Anterior or Posterior |
| Station | Is how far the fetal presenting part has descended into the mother's pelvis. |
| Cervical Effacement | Is the shortening and thinning of the cervix |
| Cervical Dilation | Is the enlargement of the cervical opening (os) from 0 to 10cm (complete dilation) |
| What are the phases of contrations | Increment: the period of increasing strengthPeak or Acme: the period of greatest strengthDecrement: The period of decreasing strength |
| Contractions are also described by their: | Average frequency; Duration; Intensity; & Interval |
| Frequency of contraction: | The elapsed time from the beginning of one contraction until the beginning of the next contraction |
| Duration of contraction: | Is the elapsed time from the beginning of a contraction until the end of the same contraction. |
| Intensity of contraction: | Is the approximate strength of the contractionDescribed as moderate, mild, or strong/firm |
| Mild Contractions | Fundus can be indented with the fingertips but with more difficulty, feels similar to the chin |
| Moderate Contractions | Fundus can be indented with the fingertips but with more difficulty, feels similar to the tip of the nose |
| Firm Contractions | Fundus cannot be readily indented with the fingertips, feels similar to the forehead |
| Interval: | Is the amount of time the uterus relaxes between contractions |
| What signs indicates that labor is usually not far away | Lightening, vaginal discharge (show), false labor, spontaneous rupture of the membranes, & cervial changes |
| Lightening | Describes what happens when the fetus begins to settle in the maternal pelvis and moves downward toward the pelvic outlet |
| Bloody Show | Caused by increased pressure in the pelvic region, a blood-tinged mucous plug becomes disloged from the cervical os |
| Braxton Hicks Contractions | Are irregular painless contractions that begin during early pregnancy and are rarely perceived by the pregnant woman |
| False Labor/ Prodromal Labor | When the cervix has not dilated and contractions remain irregular or stop |
| What is the conclusive difference between true labor and false labor? | Cervical change such as dilation which occurs with true labor |
| SROM | Spontaneous Rupture of Membranes |
| What is there a danger of when the membranes rupture | Of a prolapsed cord if the fetal head has not settled in the pelvis (the umbilical cord can descend along with the discharge of amnio fluid) |
| How is SROM differentiated from urine or vaginal fluid | A nitrazine paper test is used to determine the pH of the fluid. Amnio fluid is slightly alkaline which turns the paper blue. |
| AROM and PROM refers to: | Artificially Rupture of Membranes & Premature Rupture of Membranes |
| When does the first stage of labor begin and end? | Begins with the onset of regular contractions and is complete when the cervix is fully dilated and effaced |
| The first stage is referred to as | The stage of dilation and effacement |
| The first stage of labor is divided into what three phases | Latent, Active, and Transition |
| Latent phase | Begins with the onset of regular contractions and lasts until the cervix has dilated to at least 4cm |
| The first stage of labor may last how long? | 8-20 hours in the primipara and 5-14 hours in the multipara |
| Active Phase | Contractions are stronger and last longer, with the result that cervical dilation progresses from 4 to 7 cm |
| Transition Phase | The last part, cervical dilation completes 8 to 10cm. Contractions are more frequent, last longer, and are stronger |
| Second Stage of Labor is referred to as: | The stage of expulsion |
| When does the second stage begin and end? | Begins when the cervix is completely dilated 10cm and ends with the birth of the baby. |
| How long does the second stage usually last | From a few minutes to 2 hours |
| The third stage of labor is referred to as | The placental separation stage |
| When does the third stage of labor begins and end? | It begins with the birth of the baby and ends with the expulsion of the placenta, the average length is 5-10 minutes |
| What is the fourth stage of labor referred to as | Stage of recovery |
| When does the fourth stage of labor begin and end? | Begins with the delivery of the placenta and lasts through the first 1 to 4 hours until the mothers vital signs are stable. |
| Engagement | Occurs when the biparietal diameter of the fetal head reaches the level of the ischial spine of the mother's pelvis |
| Flexion | Occurs as the fetal head decends. Enables the smallest fetal diameter to enter the maternal birth canal |
| Internal rotation | The turning of the fetal head until the occiput is directly under the maternal symphysis pubis in preparation for birth of the head |
| Extension | Part of the birth process in which the fetal head changes position from chin on the chest to chin away from the chest (extension) |
| External rotation | The realignment of the fetal head with the shoulders after the head is delivered, and the alignment of the fetal shoulders with the mother's pelvis before delivery of the newborn. |
Created by:
mnunn5038
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