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107 Ch. 15

Labor and Birth Processes

What are 5 factors that affect process of labor and birth passenger, passageway, powers, position of mother, psychologic response
What is the passenger and what are 4 parts Passenger: fetus & placenta Parts: fetal presentation, lie, attitude, position
what is difference bn suture and fontanels of fetus Sutures: (streets)spaces bn cranial bones fontanels: 6(intersections)intersections of cranial sutures
What are two most important fontanels and where are they? Anterior: larger, diamond, close 18mos Posterior: triangle, close 6-8wks
what are 4 presenting parts on skull occiput - back vertex - crown(best) sinciput - forehead mentum - chin
what is presentation mean? What are 3 main presenting positions Which end of baby comes first cephalic - head Breech - bottom Shoulder
What are 4 variatinos of cephalic presentattion Vertex - occiput, chin tucked Military - top of head Brow Face
what are 3 variations of breech position Full/Complete - tucked (good) Frank - piked Footing - can opener
What is fetal lie and what are the variatons orientation of long axis of fetus to woman longitudinal/vertical: breech/cephalic transverse/oblique/horizontal: shoulder
what is fetal attitude and it's variations relation of fetal body parts to one another, chin tucked or not Flexion or Extension
what is fetal position location of fixed point on presenting part in relation to 4 quads of mom pelvis
what are 4 quadrants of mom pelvis r/l posterior r/l anterior
How is fetal position recorded R/L- right/left O/M/S/Sc - occiput/mentum/sacrum/scapula A/P/T - anterior/posterior/transverse ex: ROP = right occiputoposterior
How do you determine fetal position It's where the presenting part if pointing
what is ideal fetal position? What is sunny side up? OA- occipital anterior sunny side: OP - occiput posterior
What is station presenting part in relationship to pelvic ischial spines
what are possible stations 0- level with spines +1 - just below +2 - further +3 - call MD +4 - birth
What is engagement reaching or passing pelvic inlet or true pelvis, which is below ischial spines. False pelvis is above spines
What is the passageway birth canal and consists of: bony pelvis, lower uterine seg, cervix, pelvic floor muscles, vagina, introitus(ext opening of vag) Must be determined b4 labor and head is major factor in course of birth
what are parts of true pelvis inlet/brim, midpelvis/cavity, outlet
what are 4 diff pelvic types gynecoid: round, vaginal android: heart, male, c-section antropoid: oval platypelloid: horizontal oval
What are the primary and secondary powers primary: involuntary Uterine contractions - effacement,dilation, Ferguson reflex (descent/bear down) Secondary: mom pushing, bearing down efforts
what are three phases of contraction increment, acme(peak), decrement then resting phase
what is freqency of contractions end of one to beg of another
What is effacement What is dilation effacement: thinning of cervix, 0-100% dialtion: cervix opens, 1 - 10cm
What are two things that effect labor pushing and position
What is labor process of moving fetus, placenta, and membranes out of uterus adn thru birth canal
what is premonitory signs signs preceding labor: lightening/dropping in true pelvis, urinary freq, backache, braxton hicks, wt loss, energy spurt, bloody show, cervial ripen, rupture of membranes
What is difference bn true labor adn false true: discomfort in abd and back, cervical change, regular contractions that shorten, more intense False: no cervix change, irregular ctxs, no chg in interval or intensity
How many stages of labor 4 stages Stage 1: 0-10 dilation Stage 2: pushing Stage 3: delivery of placenta Stage 4: recovery
what are 3 phases of Stage 1 latent- early 1-3cm, more effacement, little dilation active: 4-7cm, dilation and descent transition: 8-10cm active-
what are 3 phases of 2nd stage of labor 1: full dilation, mild contractions, no pushing urge 2: bearing down 3: crowning til birth
What is shiny shultz and dirty duncan Shiny shultz is placenta facing fetus Dirty duncan is placenta facing mom
what are 7 cardinal mvmts of labor in vertex presentation 1. engagement 2. descent 3. flexion 4. internal rotation 5. extension 6. restitution/ext rotation 7. expulsion(birth)
how does maternal cardiovascular system change in labor incr CO, HR, BP, WBC, resp, temp decr gastric motility, blood glucose
what is normal blood loss for vag birth? C-section? vag: 500ml C-section 1000ml
what is ave FHR at term 140 beats/min normal range: 110-160
Created by: palmerag