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Questions and Answers
What is labor also known as?
Parturition, childbirth, birthing
What does the term 'parturient' refer to?
A woman in labor
What is eutocia?
What is dystocia?
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The measurement between the anterior surface of the sacral promontory and the superior margin of the symphysis pubis is known as the ______.
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What does the uterine stretch theory suggest?
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What increases as pregnancy nears term according to the oxytocin theory?
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Dystocia is defined as normal labor.
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What does CPD stand for?
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Which bones are involved in fetal skull structure?
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The measurement of the diagonal conjugate is between the sacral promontory and the ______.
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What is the smallest AP diameter of the pelvis referred to?
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The fetal spine is typically parallel to the maternal spine during labor.
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Study Notes
Labor and Delivery
- Labor is a process of regular uterine contractions that result in effacement and dilatation of the cervix, leading to the delivery of the fetus and placenta.
- Other terms for labor include Parturition, childbirth, and birthing.
- A woman in labor is considered a parturient.
- "Toco" and "Toko" (Greek) are combining forms, meaning childbirth.
- Eutocia refers to normal labor.
- Dystocia indicates difficult labor.
Theories of Labor Onset
- Uterine Stretch Theory: A hollow body organ will contract and empty its contents when stretched to its full capacity.
- Oxytocin Theory: Increased oxytocin production by the anterior pituitary as pregnancy approaches term, while oxytocinase production by the placenta decreases.
- Progesterone Deprivation Theory: Progesterone levels drop as pregnancy nears term, leading to uterine contractions.
- Theory of Aging Placenta: Decreased blood supply to the uterus due to an aging placenta triggers uterine contractions, initiating labor.
Factors Affecting Labor and Delivery Process
1. Passage (Maternal)
- Pelvic size and type, cervical effacement and dilatation, vaginal and introitus distensibility, and measurements are critical considerations.
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Important Measurements:
- Diagonal Conjugate: Measured between the sacral promontory and inferior margin of the symphysis pubis, typically 11.5 cm - 12.5 cm. Used to estimate the True Conjugate (DC - 1.5 cm = True Conjugate).
- True Conjugate/Conjugate Vera: Measurement between the anterior surface of the sacral promontory and the superior margin of the symphysis pubis, usually 11.0 cm.
- Obstetrical Conjugate: The smallest anteroposterior (AP) diameter of the pelvis, ideally 10 cm or more.
- Tuberoischi Diameter: The transverse diameter of the pelvic outlet, measured between the ischial tuberosities, typically 8 cm or more.
2. Passenger (Fetal)
- Fetal passage through the birth canal is influenced by:
- Size of the fetal head and shoulders.
- Dimensions of the pelvic girdle.
- Fetal presentation.
- Fetal position.
- Size: Primarily related to the fetal skull, with cephalopelvic disproportion (CPD) occurring when the baby's head or body is too large to fit through the mother's pelvis.
Fetal Skull
- The fetal skull is the largest presenting part and the least compressible fetal structure, making it crucial for labor and birth.
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Bones: The fetal skull comprises six bones:
- S: Sphenoid
- O: Occipital – occiput
- T: Temporal
- P: Parietal (2 x)
- F: Frontal – sinciput
- E: Ethmoid
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Sutures: Intermembranous spaces that allow molding of the skull.
- Sagittal Suture: Connects the two parietal bones.
- Coronal Suture: Connects the parietal and frontal bones.
- Lambdoidal Suture: Connects the occipital and parietal bones.
- Molding: The overlapping of the sutures of the skull, permitting passage of the head through the pelvis.
Fetal Presentation
- Vertex/Cephalic Presentation: The fetal head is the presenting part.
- Breech Presentation: The buttocks or feet are the presenting part.
- Shoulder Presentation: The shoulder is the presenting part.
Fetal Position
- LOA (Left Occiput Anterior): The fetus's head is facing the mother's left side, with the occiput anterior.
- ROA (Right Occiput Anterior): The fetus's head is facing the mother's right side, with the occiput anterior.
- LSP (Left Sacrum Posterior): The fetal sacrum is facing the mother's left side, with the sacrum posterior.
- RSP (Right Sacrum Posterior): The fetal sacrum is facing the mother's right side, with the sacrum posterior.
Fetal Lie
- Longitudinal Lie: Fetal spine is parallel to maternal spine.
- Transverse Lie: Fetal spine is 90 degrees to maternal spine, with the fetus lining horizontally.
- Oblique Lie: Fetus lies diagonally in the uterus.
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Description
Test your knowledge on the stages of labor and the various theories regarding its onset. Explore terms like eutocia and dystocia, and understand the physiological mechanisms behind childbirth. This quiz will enhance your understanding of labor processes.
