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Labor and Delivery Process
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Labor and Delivery Process

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Questions and Answers

What is the primary cause of obstructed labor?

  • Protraction disorder during the active phase
  • Prolonged latent phase
  • Cephalopelvic disproportion (CPD) (correct)
  • Kegel's exercise
  • What is the minimum duration of the latent phase for a Multi Para to be considered prolonged?

  • 16 hours
  • 14 hours (correct)
  • 10 hours
  • 12 hours
  • What is the rate of cervical dilatation during the active phase of the first stage of labor for a Nuli Para to be considered normal?

  • < 1.2 cm/hour (correct)
  • < 0.5 cm/hour
  • < 2 cm/hour
  • < 1.5 cm/hour
  • What is the duration of the second stage of labor for a Nuli Para to be considered prolonged with regional analgesia?

    <p>&gt; 3 hours</p> Signup and view all the answers

    What is the primary purpose of Kegel's exercise?

    <p>To strengthen pelvic floor muscles</p> Signup and view all the answers

    What is the definition of a prolonged third stage of labor?

    <p>Undelivered placenta &gt; 30 minutes</p> Signup and view all the answers

    What is the duration of the first stage of labor for a Multi Para to be considered abnormal?

    <p>&gt; 14 hours</p> Signup and view all the answers

    What is the definition of protraction disorder during the active phase of the first stage of labor for a Nuli Para?

    <p>Slow rate of cervical dilatation during the active phase</p> Signup and view all the answers

    What is the duration of the second stage of labor for a Multi Para to be considered prolonged with regional analgesia?

    <p>&gt; 2 hours</p> Signup and view all the answers

    What is the duration of the latent phase for a Nuli Para to be considered prolonged?

    <p>≥20 hours</p> Signup and view all the answers

    What is the fetal reference point during the journey of fetal presentation?

    <p>Presenting part</p> Signup and view all the answers

    What is the term for the relationship between the fetal longitudinal axis and that of the mother?

    <p>Fetal Lie</p> Signup and view all the answers

    What is the definition of abnormal labor?

    <p>Failure to meet time limits and progress milestones of normal labor</p> Signup and view all the answers

    What is the term for difficult labor or abnormally slow progress of labor?

    <p>Dystocia</p> Signup and view all the answers

    What is the term for any fetal presentation other than cephalic?

    <p>Malpresentation</p> Signup and view all the answers

    What is the term for the passage of a single, term, viable fetus of average weight, through the natural passages, within average duration?

    <p>Normal labor</p> Signup and view all the answers

    What is the reference point during the journey of fetal presentation?

    <p>Ischial spine</p> Signup and view all the answers

    What is the term for the fetal pole that presents at the pelvic inlet?

    <p>Fetal Presentation</p> Signup and view all the answers

    What is the term for the failure of uterine contractions to result in progressive dilation and effacement of the cervix?

    <p>Dysfunctional labor</p> Signup and view all the answers

    What is the term for a breech presentation?

    <p>Feet or Buttocks</p> Signup and view all the answers

    What is the primary function of the labor process?

    <p>To expel the products of conception out of the uterus</p> Signup and view all the answers

    During which stage of labor does the latent phase occur?

    <p>First stage</p> Signup and view all the answers

    What is the rate of dilatation during the active phase of the first stage of labor in a primipara?

    <p>1.2 cm/hour</p> Signup and view all the answers

    What is the duration of the second stage of labor in a multipara?

    <p>1 hour</p> Signup and view all the answers

    What is the result of uterine retraction during labor?

    <p>Permanent shortening of muscle fibers</p> Signup and view all the answers

    What is the additional force that assists in the expulsion of the fetus?

    <p>Maternal pushing using abdominal and diaphragmatic muscles</p> Signup and view all the answers

    During which stage of labor does the descent of the fetal head occur?

    <p>Second stage</p> Signup and view all the answers

    What is the duration of the third stage of labor in both primipara and multipara?

    <p>30 minutes</p> Signup and view all the answers

    What is the result of uterine contractions on the cervix during labor?

    <p>Dilatation of the cervix</p> Signup and view all the answers

    What is the role of the obstetric pelvic axis during labor?

    <p>To guide the fetal head during delivery</p> Signup and view all the answers

    Study Notes

    Definition of Labor

    • Labor is a physiologic process where the female genital organs work to expel the products of conception (fetus, membranes, umbilical cord, and placenta) out of the uterus through the vagina.
    • It involves a series of events to achieve this goal.

    Stages of Labor

    • First stage: from onset of regular contractions to complete cervical dilation.
      • Latent phase: gradual cervical change (up to 4 cm dilatation).
      • Active phase: rapid cervical change (at least 1 cm dilatation/hour).
      • Passive phase: from complete cervical dilation to onset of active maternal expulsive efforts.
    • Second stage: from complete cervical dilation to expulsion of the fetus.
      • Active phase: from beginning of active maternal expulsive efforts to expulsion of the fetus.
    • Third stage: from expulsion of the fetus to expulsion of the placenta.
      • Duration: approximately 30 minutes in both primipara (PG) and multipara (MP).

    1st Stage of Labor

    • Onset: start of labor pain.
    • Offset: full cervical dilation.
    • Phases:
      • Latent: up to 4 cm.
      • Active: from 4 cm to full cervical dilation.
    • Rate of dilation:
      • Primipara (PG): 1.2 cm/hour.
      • Multipara (MP): 1.5 cm/hour.
    • Duration:
      • Primipara (PG): 12 hours.
      • Multipara (MP): 6 hours.

    2nd Stage of Labor (Delivery)

    • Onset: full cervical dilation.
    • Offset: fetal delivery.
    • Duration:
      • Primipara (PG): 2 hours.
      • Multipara (MP): 1 hour.

    3rd Stage of Labor

    • Onset: fetal delivery.
    • Offset: delivery of the afterbirth (placenta + cord + membranes).
    • Duration: approximately 30 minutes in both primipara (PG) and multipara (MP).

    Power and Passages

    • Uterine contractions and retractions:
      • Contraction: temporary shortening of muscle fibers.
      • Retraction: shortening of muscle fibers with permanent shortening.
    • As a result of uterine contractions:
      • Dilatation of cervix.
      • Descent of fetus and delivery.
      • Delivery of placenta.
      • Stoppage of postpartum bleeding.
    • Additional force: maternal pushing (abdominal and diaphragmatic muscles).

    Fetal Presentation

    • Cephalic: head first.
    • Breech: feet or buttocks.
    • Shoulder: back or abdomen.
    • Malpresentation: any fetal presentation other than cephalic.

    Normal Labor

    • Passage of a single, term, viable fetus of average weight.
    • Cephalic presentation through the natural passages.
    • Within average duration from spontaneous onset of uterine contractions.
    • With no interventions (except episiotomy) and no complications to the mother or fetus.

    Abnormal Labor

    • Failure to meet time limits and progress milestones of normal labor.
    • Terms that are often used: dystocia, dysfunctional labor, failure to progress, and cephalopelvic disproportion (CPD).
    • Obstructed labor: failure of fetal delivery in spite of strong uterine contractions due to mechanical obstruction.

    Types of Abnormal Labor

    • Prolonged latent phase: ≥20 hours for the Nuli Para and ≥14 hours for the Multi Para.
    • First stage abnormalities:
      • Protraction disorder: slow rate of cervical dilatation.
      • Arrest disorder: no cervical change for 1 hour despite adequate contractions.
    • Second stage abnormalities:
      • Protraction disorder: slow rate of descent.
      • Arrest disorder: no progress (descent, rotation) for 1 hour.
    • Prolonged third stage: undelivered placenta > 30 minutes.

    Kegel's Exercise

    • Pelvic-floor exercise: repeatedly contracting and relaxing the muscles that form part of the pelvic floor.
    • The exercise can be performed many times a day, for several minutes at a time, but takes 1-3 months to begin to have an effect.

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    Related Documents

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    Description

    This quiz covers the definition and stages of labor, including the latent phase, during which a series of events take place to expel the products of conception from the uterus.

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