-
Causative factors of labor
- Uterine stretch
- Prgesterone withdrawal
- Increased Oxytocin sensitivity (causes contractions)
- Increased release of prostaglandis
-
Premonitory signs of labor
Cervical changes:________
______: fetal presenting part descends into pelvis
______: sudden increase in energy before labor (occurs 24 - 48 hours before labor)
1.
2.
3.
- Cervical changes: softening and dilation
- Lightening: fetal presenting part descends into pelvis
- Nesting: sudden increase in energy before labor
- 1. Bloody show
- 2. Braxton hicks contractions
- 3. Spontaneous rupture of membranes (SROM)
-
False Labor
Contraction timing:
Contraction strength:
Contraction discomfort:
Any change in activity:
Cervical change:
Stay or go?
- Contraction timing: Irregular
- Contraction strength: Frequently weak, or alternating b/w strong and weak
- Contraction discomfort: Felt in front of abdomen
- Any change in activity: Contractions may stop or slow down with walking or position changes
- Cervical change: No
- Stay or go? Drink fluids and walk to determine change in intensity. If no change or less painful, stay home.
-
True Labor
Contraction timing:
Contraction strength:
Contraction discomfort:
Any change in activity:
Cervical change:
Stay or go?
- Contraction timing: Regular 4 - 6 minutes apart, lasting 30 - 60 seconds
- Contraction strength: Stronger with time
- Contraction discomfort: Starts in back and radiates to abdomen
- Any change in activity: Contractions continue no matter what position change is made
- Cervical change: Yes
- Stay or go? Come to hospital when contractions are 5 min apart lasting 45 - 60 seconds and difficult to talk trough
-
The 5 P's of labor
- Passageway (Birth canal)
- Passenger (Baby)
- Powers (pushes/contractions)
- Position (off back)
- Psychological response (Get ready to deliver)
-
Passageway: Pelvis
True pelvis:
False pelvis:
Soft tissues:____, _____, _____
- True pelvis: Represents the bony limits of the birth canal
- False pelvis: Supports the weight of the uterus, shallow basin above the inlet or brim
- Soft tissues: Cervix, pelvic floor muscles, vagina
-
Pelvic shape
_____: Most favorable, 50% of women.
_____: 25% of women, favorable
_____: 20% of women, funnel shape, not favorable
_____: 5% of women, least favorable
- Gynecoid: most favorable
- Anthropoid: favorable
- Android: not favorable
- Platypelloid: least favorable
-
Passenger: baby
1. Fetal H
2. Fetal A
3. Fetal L
4. Fetal P
5. Fetal P
6. Fetal S
7. Fetal E
8. Cardinal movements of labor
- 1. Head
- 2. Attitude
- 3. Lie
- 4. Presentation
- 5. Position
- 6. Station
- 7. Engagement
- 8. Cardinal movements of labor
-
Fetal head
Largest and least compressible
Sutures not fused
Fontanelles
______: soft spot
______ shaped, measures _____
Remains open 12 - 18 months
Posterior: soft spot
_______ shape
Measures ____
Closes _____
______: elongated shape of skull r/t overlapping of cranial bones.
- Anterior: soft spot
- Diamond shaped, measures 1 - 4 cm
- Remains open 12 - 18 months
- Posterior: soft spot
- Triangular shape, measures 1 - 2 cm
- closes 8 - 12 weeks
- Molding: elongated shape of skull r/t overlapping of cranial bones
-
Fetal head
_______: fluid collected under scalp
Crosses sutures, usually benign
_______: blood collected b/w periosteum and bone.
Does not cross sutures
Generally reabsorbed
- Caput Succedaneum: fluid collected under scalp
- Cephalohematoma: Blood collected b/w periosteum and bone
-
Fetal lie
Relationship of ____ of fetus to ____ of mother
A.
B.
- Relationship of spine of fetus to spine of mother.
- A. Longitudinal lie
- B. Transverse lie (laying across)
-
Fetal presentation
Cephalic
- Vertex (head down)
- Military (straight ahead)
- Brow (looking up)
- Face (neck all the way back)
-
Fetal presentation
Breech
- Frank (Butt first, feet up towards head)
- Complete (Butt first, legs crossed)
- Single footling (feet first, one)
- Double (feet first, both)
-
Fetal position
Describes the relationship of a given point on presenting part of fetus to a designated point on maternal pelvis
O
M
S
S
- Occipital (O) (back of head)
- Mentum (M) (face)
- Sacrum (S) (Butt first)
- Scapula (A) (transverse lie)
-
Fetal position
1st letter defines which direction presenting part (right or left)
2nd letter determines presenting part of fetus (OMSA)
3rd letter determines location of presenting part in regards to maternal pelvis
(anterior, Posterior, Transverse)
- Examples:
- Right occiput anterior
- Right occiput
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