M&B test 3
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| Physiologic primary force of labor is | uterine muscular contractions.
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| Physiologic secondary force of labor is | use of abdominal muscles to push during second stage of labor.
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| When pushing...Dont to soon can risk | ripping of cervix (if not complete), more swelling, and exhaustion!
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| Progesterone causes | relaxation of smooth muscle tissue
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| Estrogen causes | stimulation of uterine muscle contradiction.
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| connective tissue loosens | and permits softening, thinning, opening of cervix
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| Psychosocial considerations for a woman giving birth | Understanding and preparing for childbirth experience, Amount of support from others, present emotional status, Beliefs and values.
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| Physical things to look at from stress of labor (Mom) | Respiratory Alkalosis from hyperventillating
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| Physical things to look at from stress of labor (baby) | acidotic less than plt 7.25.
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| The more times you check mom | more risk of infection
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| Thinning of Cervix is called | Effacement
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| Effacement | Muscles of upper uterine segment shorten and cause cervix to thin and flatten.
Fetal body straightened as uterus elongates with each contraction.
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| If cervix is thick, long and hard | not going to deliver.
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| Contraction | Pressure of fetal head causes cervical dilation and thin out cervix, rectum and vagina are drawn upward and forward with each contraction, During second stage, anus everts
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| lightening | Fetus descends into pelvic inlet
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| Braxton hicks contractions | Irregular, intermittent contractions that occur during pregnancy, cause more discomfort closer to onset of labor.
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| cervical changes | cervix begins to soften and weaken (ripening)
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| Bloody show | loss of cervical mucous plug, cause blood-tinged discharge (never dismiss it! look at volume and circumstance surrounding)
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| Check for rupture | nitrozene paper - turns blue (amnionic fluid), Best test Speculum test, Fern test, Diffinative slide test shows ferning under microscope
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| nesting | Sudden burst of energy, usually occurs 24-48 hours before onset of labor.
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| Rupture of membranes | If rupture prior to onset of labor, good chance labor will begin within 24 hours. ( risk of infection or preterm labor and or/ delivery)
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| Premonitory signs of labor | loss of 1 to 3 pounds, Diarrhea, indigestion, nausea, vomiting may occur prior to onset of labor.
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| True labor characterized by | Contractions at regular intervals- increase in duration and intensity
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| Cardinal Movements in Delivery | Decent, flexion, Internal Rotation, Extension, Restitution, Expulsion
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| Decent | The head enters the pelvic inlet in the occiput, transverse or oblique position because the inlet is widest from side to side.
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| In Decent...present in 3 ways | Occiput, transverse, oblique
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| Four forces affecting decent | 1, pressure of amniotic fluid, 2, direct pressure of the uterine fundus on the breech, 3, contraction of abdominal muscles, 4, extennsion and strengthening of the fetal body.
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| Flexion | fetal chin flexes downward onto the chest
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| Internal Rotation | Head rotates inside the pelvic cavity from left to right.
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| Extension | The occiput, then brow and face emerge from the vagina
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| Restitution | Shoulders enter pelvic inlet obliquely and remain oblique when the head rotates to the anteroposterior diameter thru internal rotation.
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| restitution | turning the head to one side, and aligns with position of the back in the birth canal.
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| Expulsion | The anterior shoulder quickly born before the posterior and the body quickly follows engagement.
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| Engagement | Presenting part occurs when largest diameter of presenting part reaches or passes thru pelvic inlet.
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| Engagement | can be determined by a sterile vaginal exam (to see if baby is blottable)
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| Engagement | Confirms adequacy of pelvic inlet (does not indicate whether the mid pelvis and outlet are adequate)
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| Engagement | Usually occurs a couple weeks before term.
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| Once head is engaged | there is a less chance of cord prolapse.
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| station | relationship of presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis, the ischial spines are 0 station, if presenting part is higher -, if below + number.
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| fetal postiion | Refers to the relationship of a designated landmark on the presenting fetal part to the front, sides or back of the maternal pelvis.
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| Lightening | moving of the fetus and uterus downward into the pelvic cavity
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| hyperventalation | numbness tingling in fingers or lips give paper bag to breathing.
Imbalance o2 and co2...too much 02, shallow breaths, slow breathing, count out loud.. need more co2 in
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| Pushing | Woman uses intra-abdominal pressure, Perineum begins to bulge, flatten and move anteriorally, bloody show may increase, labia begin to part with each contraction.
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| Crowning | fetal head is encircled by the external opening of the vagina, birth is imminent
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| Frequency (Contraction) | The time between the beginning of one contraction to the beginning of the next contraction
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| Duration (Contraction) | The beginning of a contraction to the completion of that same contraction.
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| if cervix is not completely dilated (10cm), bearing down (pushing) can cause | cervical edema, possible tearing and bruising of the cervix and maternal exhaustion
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| Intensity (contraction) | Refers to the strength of the contraction during acme.
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| Acme | Peak of contraction
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| Intensity can be estimated | by palpating the uterine fundus during a contraction.by judging the amount of indentablility of the uterine wall during acme of a contraction.
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| intensity can be measured | by an intrauterine catherter.
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| Fetal response to labor | heart rate may decrease as head pushes against cervix
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| Fetal response to labor | Decrease in pH due to decreased blood flow at peak of each contraction
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| Fetal response to labor | Further decrease of ph occurs during pushing due to woman holding her breathe.
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| Fetal postition | Refers to the relationship of a designed landmark on the presenting fetal part to the front, sides or back of the maternal pelvis.
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| 1st postition | right or left of the maternal pelvis
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| 2nd position | Fetal presenting part: Occiput (O), mentum(M) which is the face, and sacrum (S), acromion process (A)
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| 3rd position | Anterior (A), posterior (P) or transverse (T) (front, back or side of the pelvis)
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| Most common position.. safe for delivery | LOA, ROA
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| If baby position is posterior | really hard to get out (c-section)
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| Fetal lie | Relationship of spine of baby...want longitudinal lie (up & down) or transverse lie (side ways)...move baby or c-section.
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| effacement | thinning of the cervix based on a subjective percentage determined with a sterile vag exam. 100% fully effaced.
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| First Stage | Begins with onset of true labor and ends when the cervix is dialated to 10cm,
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Created by:
CHARLIA
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