Term
| describe the change in oxytocin during labor: |
|
Definition
| oxytocin levels don't rise significantly but there is a significan upregulation of oxytocin receptors (80% increase) |
|
|
Term
| define braxton hicks contractions: |
|
Definition
| contractions without changes in cervix |
|
|
Term
|
Definition
| when the baby is dropping into position |
|
|
Term
| 3 maternal changes before labor: |
|
Definition
1. uterine contractions
2. lightening
3. bloody show (mucus) |
|
|
Term
| what are considered adequate contractions during labor: |
|
Definition
|
|
Term
| what is meant by the fetus attitude? |
|
Definition
|
|
Term
| pelvic shape: most common and optimal for delivery |
|
Definition
|
|
Term
| intrapartum triage steps:5 |
|
Definition
1. maternal/fetal vital signs
2. fetal lie and presentation
3. contractions
4. cervical exam
5. fetal movement |
|
|
Term
| define: liopold maneuver: |
|
Definition
| palpating the fetus through maternal abdomen to asses the lie, presentation, and position |
|
|
Term
| 3 examples of the fetal lie: |
|
Definition
1. longitudinal
2. transverse
3. oblique |
|
|
Term
| 2 examples of the fetal presentation: |
|
Definition
|
|
Term
| what is meant by fetal position? |
|
Definition
| fetal presentation + left or right |
|
|
Term
| which is the optimal position of the fetus for delivery? |
|
Definition
| Left Occipito Anterior - LOA |
|
|
Term
| describe the 4 stages of labor: |
|
Definition
1. onset to full dilation
2. 10cm thru delivery
3. delivery of infant to delivery of placenta
4. 2hrs after delivery of placenta |
|
|
Term
| describe the 2 phases within the first stage of labor: |
|
Definition
1. latent phase: cervical effacement and early dilation (3-4cm/8hrs)
2. active phase: more rapid cervical dilation occurs 4-10cm/6hrs |
|
|
Term
| within the first stage of labor: lack of progression in dilation/descent may represent |
|
Definition
|
|
Term
| which stage of labor is the pushing stage? |
|
Definition
|
|
Term
| define caput succedaneum of the fetal head: |
|
Definition
|
|
Term
| define molding of the fetal head: |
|
Definition
| bones overlapping causing the characteristic cone shape |
|
|
Term
| what should be monitored during stage II |
|
Definition
1. fetal descent
2. fetal heart sounds (after every contraction in patients with OB RF) |
|
|
Term
| 7 cardinal fetal movements of labor: |
|
Definition
1. engagement (into canal)
2. flexion
3. descent
4. internal rotation
5. extension
6. external rotation
7. expulsion |
|
|
Term
| which cranial presentation is desired? |
|
Definition
|
|
Term
| describe the Ritgen maneuver: |
|
Definition
| applied pressure on the perineum with one hand to help deliver the head and the other hand on the fetal head to control the rate of delivery |
|
|
Term
| within the second stage of labor, describe the steps of delivery: |
|
Definition
1. Ritgen maneuver
2. once head is delivered, clear oralcavity and nares
3. check for meconium and cord around neck
4. deliver anterior shoulder w downward traction on externally rotated head
5. deliver posterior shoulder by elevating head
6. body delivered with traction on teh shoulders
7. cord is clamped and cut within 15-20seconds |
|
|
Term
| define the third stage of labor: |
|
Definition
| time from delivery of infant to separation and expulsion of the placenta |
|
|
Term
| signs of placental separation generally occur ______ following stage 2: |
|
Definition
|
|
Term
| potential complication of the uterus during placental delivery |
|
Definition
| descent of uterus into pelvis |
|
|
Term
| 2 things that can be used to reduce bleeding after delivery of the placenta: |
|
Definition
1. uterine massage
2. oxytocin |
|
|
Term
| name the 4 degrees of perineal lacerations: |
|
Definition
1. involves vaginal mucosa or perineal skin
2. involves subcu tissues, with or without the involvement of muscles of the perineal body
3. through the rectal sphincter but not through the rectal mucosa
4. extends into the rectal mucosa |
|
|
Term
| define the 4th stage of labor: |
|
Definition
| immediate post partum period (2hrs) following delivery of the placenta |
|
|
Term
| 4 absolute contraindications to vaginal delivery: |
|
Definition
1. complete placenta previa
2. HSV lesions or prodrome sx
3. previous classic uterine incision
4. untreated HIV |
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