Princinples II PROGRESS OF LABOR AND PAIN
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| WHO MANY STAGES OF LABOR DO WE HAVE | THERE ARE THREE STAGES OF LABOR
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| WHAT IS THE FIRST STAGE OF LABOR | IT IS THE ONSET OF REGULAR CONTRACTIONS (LATENT AND ACTIVE STAGES)ENDS WITH FULL CERVICAL DILATION (10 CM AT TERM)
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| WHAT IS THE SECOND STAGE OF LABOR | IT BEGINS WITH FULL DILATION OF THE CERVIX, ENDS WITH DELIVERY OF INFANT
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| WHAT IS THE THIRD STAGE OF LABOR | DELIVERY OF INFANT UNTIL THE PLACENTA IS EXPELLED
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| PAIN DURING LABOR ARE CLASSIFIED AS WHAT | VISCERAL AND SOMATIC PAIN.
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| WHAT IS VISCERAL PAIN | VISCERAL PAIN IN ORIGIN CAUSED BY UTERINE CONTRACTIONS AND DILATION OF THE CERVIX.
AUTONOMIC C FIBERS THAT ENTER THE DORSAL HORN OF THE SPINAL CORD AT T10-L1 (DULL, ACHING PAIN)
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| WHAT IS SOMATIC PAIN | Somatic pain is due to stretching of the vagina and perineum by descent of the fetus
-Pudendal nerves -> enter spinal cord at posterior roots of S2-4; A-Delta fiber stimulation
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| what does regional techniques do? | Regional techniques decrease likelihood of fetal drug depression and maternal pulmonary aspiration
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| should regional anesthesia influence progression of labor | No. Should not influence the progress of labor or ability to bear down during the second stage of labor
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| what are some abnormal presentation of births | 90% of deliveries are cephalic presentation in either occiput transverse or occiput anterior position
Persistent occiput posterior
Breech presentation
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| what consideration should you have with multiple gestations | Consider prematurity and breech presentation
Usually cesarean section
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| dx of fetal distress is monitoring for what. | beat-to-beat variability; early deceleration, late deceleration, variable deceleration
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| what is beat-to-beat variability | Fetal heart rate varies 5 to 20 beats/min
Normal FHR ranges between 110 and 160 beats/min
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| what is early decelerations | Characterized by slowing of the FHR that begins with the onset of uterine contraction
Not indicative of fetal distress
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| what is late deceleration | Characterized by slowing of the FHR that begins 10 to 30 seconds after the onset of uterine contraction
Associated with fetal distress
Determination of fetal scalp pH is recommended when this pattern permits
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| what is variable decelerations | Variable in magnitude, duration, and time of onset
Generally characterized by a steep descent of FHR
Thought to be caused by umbilical cord compression
Unless prolonged, they are usually benign
Consider changing maternal position
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| what is apgar score | It is used to evaluates heart rate, breathing, reflex irritability, muscle tone, and color.
Numerical value assigned 1 and 5 minutes after delivery
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| Neonatal evaluation and resuscitation are | Apgar score evaluates heart rate, breathing, reflex irritability, muscle tone, and color
Numerical value assigned 1 and 5 minutes after delivery
Suctioning
Vascular resuscitation:
Umbilical arterial catheter may be inserted (ABGs)
Evaluate and trea
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| what does the umbilical cord do | there are 2 umbilical arteries (carry blood away from the fetus) and one umbilical vein carries oxyginated blood to the fetus
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