Maternal and Child Health Nursing I

Labor and Delivery

• True labor features regular contractions, abdominal discomfort, fetal descent, bloody show, and cervical dilation/effacement.
• Fetal station indicates fetal position relative to ischial spine; measured in centimeters as negative (above) or positive (below), with station 0 at the spine.
• Engagement occurs when the largest diameter of the presenting part passes through the pelvic inlet.
• Floating indicates the fetal presenting part is not engaged and is freely movable above the pelvic inlet.
• Uterine contractions have three phases: increment, acme, and decrement.

Maternal Health

• Pregnancy weight gain averages between 25 to 30 lb (11 to 13.5 kg).
• Pregnancy-induced hypertension (preeclampsia) can be identified by a blood pressure increase of 30/15 mm Hg over baseline or 140/95 mm Hg on two occasions post 20 weeks, combined with edema and albuminuria.
• Women should avoid alcohol during pregnancy, as no safe level of intake exists.
• Goodell’s sign indicates cervix softening, occurring in early pregnancy.
• Chloasma, or the mask of pregnancy, presents as facial pigmentation over the cheeks and nose.

Neonate Considerations

• Excessive oxygen in premature neonates can lead to retrolental fibroplasia, a cause for blindness.
• If the umbilical cord is tight around a neonate's neck during delivery, it should be clamped and cut if it cannot be loosened.
• Apgar scores range from 0 to 10, with scores of 7-10 indicating no distress and scores of 0-3 indicating severe distress.
• To assess jaundice in neonates, examine under natural light; if unavailable, use white light.
• Cow’s milk is not recommended for infants under one year due to its protein content and low linoleic acid levels.

Breastfeeding and Infant Reflexes

• To break suction while breastfeeding, insert a finger at the corner of the infant's mouth.
• Eliciting the Moro reflex involves gently dropping the neonate’s head backward, triggering an abduction and extension response of the extremities.

Pregnancy Monitoring

• Measure rubella immunity using a hemagglutination inhibition test; a titer above 1:8 indicates immunity.
• Vaginal bleeding during pregnancy should be treated as a potential complication until proven otherwise.
• Fundal height at 12 weeks’ gestation should reach the symphysis pubis.

Ovulation and Signs of Pregnancy

• Ovulation ceases during pregnancy; positive pregnancy signs include ultrasound, fetal heart tones, and examiner-felt fetal movement (normally after 4 months).
• Quickening, or the first fetal movements felt by the mother, typically occurs between 16 and 19 weeks’ gestation.

Delivery Date Calculation

• Estimate the delivery date using Nägele’s rule by counting backward 3 months from the last menstrual period and adding 7 days.

Maternal Positions During Labor

• The side-lying position often provides comfort during the first stage of labor, though any comfortable position is acceptable for the patient.

Pelvic Types

• Gynecoid pelvis is the most favorable for delivery; other types include platypelloid (flat), anthropoid (apelike), and android (male-like).