Labor and Delivery Process

Podcast

Play an AI-generated podcast conversation about this lesson

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?

> 3 hours Signup and view all the answers

What is the primary purpose of Kegel's exercise?

To strengthen pelvic floor muscles Signup and view all the answers

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

Undelivered placenta > 30 minutes Signup and view all the answers

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

> 14 hours 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?

Slow rate of cervical dilatation during the active phase 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?

> 2 hours Signup and view all the answers

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

≥20 hours Signup and view all the answers

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

Presenting part Signup and view all the answers

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

Fetal Lie Signup and view all the answers

What is the definition of abnormal labor?

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

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

Dystocia Signup and view all the answers

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

Malpresentation 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?

Normal labor Signup and view all the answers

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

Ischial spine Signup and view all the answers

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

Fetal Presentation 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?

Dysfunctional labor Signup and view all the answers

What is the term for a breech presentation?

Feet or Buttocks Signup and view all the answers

What is the primary function of the labor process?

To expel the products of conception out of the uterus Signup and view all the answers

During which stage of labor does the latent phase occur?

First stage 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?

1.2 cm/hour Signup and view all the answers

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

1 hour Signup and view all the answers

What is the result of uterine retraction during labor?

Permanent shortening of muscle fibers Signup and view all the answers

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

Maternal pushing using abdominal and diaphragmatic muscles Signup and view all the answers

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

Second stage Signup and view all the answers

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

30 minutes Signup and view all the answers

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

Dilatation of the cervix Signup and view all the answers

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

To guide the fetal head during delivery 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.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

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.