maternity
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| show | pelvis, passenger, pelvis/presenting part, power, psyche
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| Types of pelvis | show 🗑
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| show | favorable, rounded, nl female caucasian
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| show | not favorable, heart shaped, male, narrow
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| anthropoid | show 🗑
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| platypelloid | show 🗑
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| show | sutures, mentum, sinciput, occiput, fontanelles,
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| sutures | show 🗑
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| fontanelles | show 🗑
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| show | chin
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| sinciput | show 🗑
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| show | go together, area between fontanelles
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| show | also area of anterior fontanelle, where coronal and saggital sutures meet
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| show | flexion
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| fetal lie | show 🗑
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| show | body part of fetus at pelvic passage
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| vertex presentation (subocciptobregmatic) | show 🗑
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| show | no flexion or extension, presenting part top of head
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| brow presentation (submentobregmatic) | show 🗑
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| face presentation (occipitomental) | show 🗑
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| show | but of feet presenting first (complete, frank, or footling)
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| transverse lie | show 🗑
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| engagement | show 🗑
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| show | relation of presenting part with ischial spine. -5 to +5..fully dilated at +2 or 3
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| fetal position | show 🗑
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| Powers-contractions | show 🗑
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| primary force | show 🗑
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| show | use of ab muscles to push during 2nd stage of labor, adds to primary force after full dilation
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| show | accomplish task of pregnancy, coping mechanism, previous experience, support, preparation, cultural influences
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| physiology of labor | show 🗑
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| show | decrease progesterone allows estrogen to stimulate contractions. progesterone is administered to prevent preterm birth. increases 10x during pregnancy then drops
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| show | used to induce labor, inhibitor of prostaglandin in used to stop preterm birth (PGE)
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| show | increase throughout pregnancy with sharp increase at term. known to stimulate prostaglandin F & E by amnion cells
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| effacement | show 🗑
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| myometrial activity | show 🗑
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| signs of labor | show 🗑
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| show | goes from rigid and firm to weak and soft. collagen fibers decrease and water increases. softening of cervix=ripening
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| braxton-hicks contractions | show 🗑
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| show | baby drops making easier to breath but sitting on bladder and frequent urinating
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| bloody show | show 🗑
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| SROM | show 🗑
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| AROM | show 🗑
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| burst of energy | show 🗑
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| true labor | show 🗑
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| false labor | show 🗑
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| show | feel free to come in for exam only way to tell is by vaginal exam, hard to distinguish the difference
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| stages of labor | show 🗑
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| show | true labor until 10cm dilation. SROM/AROM occurs. 3 phases: latent/early phase, active phase, transition phase
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| show | 0-3cm, beginning of regular contractions, talking and smiling, increase in I,F,D
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| show | 4-7cm, nl ask for epidural, fetal descent progressive, insrease anxiety and pain, decrease coping
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| transition phase | show 🗑
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| second stage | show 🗑
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| show | DIDRED, descent thru pelvis, internal rotation, delivery and extension of head, restitution (baby stops), external rotation, delivery of shoulders.
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| third stage | show 🗑
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| types of placent | show 🗑
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| fourth stage | show 🗑
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| show | remains contracted in midline of ab, fundus midway between symphysis pubis&umbilicus, N/V cease, thirsy&hungry, shaking chills
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| show | labor and birth effect almost all maternal physiological systems
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| mom cardiovascular changes | show 🗑
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| show | sweating, IV fluids or oral fluids needed
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| mom respiratory changes | show 🗑
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| mom renal system changes | show 🗑
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| show | gastric motility, absorption, and emptying time decreased while stomach volume remain increased.
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| mom immune system and blood values changes | show 🗑
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| reasons for pain in labor | show 🗑
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| factors affecting response to pain | show 🗑
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| fetal HR changes | show 🗑
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| fetal acid base status in labor | show 🗑
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| show | fetal reserve is enough to see the fetus through anoxic periods unharmed
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| fetal behavioral states | show 🗑
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| show | @37-38 weeks fetus can experience light, sound, and touch. fetus experiences labor as women labors
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| show | name, age, hx, LMP, EDB, physician, blood type, HPI, problem in prenatal, pregnancy data, feed method, ed, NST, BPP,
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| intrapartal risk screening | show 🗑
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| assessment of labor progress | show 🗑
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| contraction assessment | show 🗑
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| show | dilation&effacement evaluated, vaginal exam can also provide info about membrane status, amniotic fluid, fetal position and station
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| determination of fetal position and presentation | show 🗑
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| show | handheld doppler ultrasound or fetoscope used, most clearly heard at fetal back
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| leopolds maneuver | show 🗑
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| EFM | show 🗑
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| show | average FHR
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| show | interplay between sympathetic and parasypathetic over 10min period. absent, minimal, moderate, marked
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| show | increase in FHR normally cause by fetal movement
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| show | decrease FHR from decreased blood flow, compression of fetal head
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| types of FHR decelerations | show 🗑
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| early FHR decelerations | show 🗑
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| late FHR decelerations | show 🗑
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| variable FHR decelerations | show 🗑
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| show | waveform, anemia, hypoxia
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| show | result from vaginal exams
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| intermittent FHR decelerations | show 🗑
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| show | leave baseline for 2 min but no more than 10 min.
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| BUBBLE H2E | show 🗑
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| show | 120-160 bpm
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| show | 30-60
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| nl fetal temp | show 🗑
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| electronic monitoring | show 🗑
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| show | assesses contraction pattern, continuous tracing of contraction pattern, allows for evaluation of effectiveness of labor.
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| uterine external and internal monitors | show 🗑
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| Purpose of fetal monitoring | show 🗑
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| fetal external and internal monitors | show 🗑
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| show | non-invasive, can be done at any time, does not require ROM, can monitor multiples
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| show | belts may be cumbersome, tracing may be affected by artifact/movement, only shows F&D for uterus, only show LTV for fetus
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| show | shows LTV and STV, direct measure of FHR, no gaps in tracing, more comfortable, can measure intensity
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| internal monitoring disadvantages | show 🗑
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| BPP-all done by ultrasound except FHR done NST | show 🗑
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| BPP is indicated when.. | show 🗑
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| show | evaluate fetal status, should show at least 2 accelerations of FHR with fetal movement on 15bmp lasting 15s or more over 20min
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| AFI | show 🗑
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| fetal scalp blood sampeling | show 🗑
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| scalp stimulation test | show 🗑
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| cord blood analysis | show 🗑
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