Podcast
Questions and Answers
Which of the following is NOT a characteristic of normal labor?
Which of the following is NOT a characteristic of normal labor?
During which stage of labor does the cervix fully dilate?
During which stage of labor does the cervix fully dilate?
What is the term used for the stage of labor when the cervix is dilated from 4 cm to about 10 cm?
What is the term used for the stage of labor when the cervix is dilated from 4 cm to about 10 cm?
What is the term used to describe the fetal head being encircled by the vulvar ring during delivery?
What is the term used to describe the fetal head being encircled by the vulvar ring during delivery?
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Which of the following terms describes the relationship between the fetal spine and the maternal spine?
Which of the following terms describes the relationship between the fetal spine and the maternal spine?
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What indicates the external rotation of the fetal head during delivery?
What indicates the external rotation of the fetal head during delivery?
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What is a clinical feature of shoulder dystocia?
What is a clinical feature of shoulder dystocia?
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During the slow delivery of the fetal head, what is the primary purpose of using one hand to support the perineum?
During the slow delivery of the fetal head, what is the primary purpose of using one hand to support the perineum?
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What is the goal during the third stage of labor?
What is the goal during the third stage of labor?
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What happens to the fetal head after its delivery?
What happens to the fetal head after its delivery?
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What is the approximate incidence of shoulder dystocia in all deliveries?
What is the approximate incidence of shoulder dystocia in all deliveries?
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Which management option is aimed at ensuring an intact placenta during delivery?
Which management option is aimed at ensuring an intact placenta during delivery?
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What should be avoided during the third stage of labor to prevent complications?
What should be avoided during the third stage of labor to prevent complications?
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Flashcards
Normal Labor
Normal Labor
Spontaneous onset of labor with low-risk delivery conditions for mother and infant.
Stages of Labor
Stages of Labor
Three distinct phases: first (cervix dilates), second (baby is delivered), third (placenta is delivered).
First Stage - Latent Phase
First Stage - Latent Phase
Phase when cervix is dilated about 4 cm; contractions start but are usually mild.
Crowning
Crowning
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Perineum Changes During Delivery
Perineum Changes During Delivery
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Delivery of the Head
Delivery of the Head
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External Rotation of Head
External Rotation of Head
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Shoulder Dystocia
Shoulder Dystocia
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Clinical Features of Shoulder Dystocia
Clinical Features of Shoulder Dystocia
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Third Stage of Labour
Third Stage of Labour
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Goals of Third Stage Management
Goals of Third Stage Management
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Active Management of Placenta
Active Management of Placenta
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Expectant Management of Placenta
Expectant Management of Placenta
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Study Notes
Labor
- Normal labor involves stages, cardinal movements, intrapartum periods, and breech presentations.
- Normal births are spontaneous, starting with a low-risk situation and remaining so throughout the labor and delivery process, typically occurring between 37 and 42 weeks of pregnancy. The infant is in the vertex position.
- The first stage of labor begins with uterine contractions and continues until the cervix is fully dilated (10cm). It has a latent phase (cervix dilated about 4 cm) and an active phase (cervix dilated from 4 cm to about 10 cm).
- The second stage of labor begins when the cervix is fully dilated and ends when the baby is delivered.
- The third stage of labor begins when the baby is delivered and ends when the placenta is delivered. Goals include delivering an intact placenta, avoiding uterine inversion, and avoiding postpartum hemorrhage.
- Active management of the placenta involves giving uterotonic drugs to help contract the uterus, clamping the umbilical cord early, and applying traction to the cord to deliver the placenta. Expectant management is an alternative approach.
Stages of Labor
- First stage: Begins with uterine contractions and ends when the cervix is fully dilated (10cm). This stage is divided into latent (cervix dilated about 4cm) and active (cervix dilated from 4cm to about 10cm) phases.
- Second stage: Begins with a fully dilated cervix and ends with the baby's delivery.
- Third stage: Begins with the baby's delivery and ends with the delivery of the placenta.
Delivery of the Head
- With each contraction, the vulvovaginal opening dilates, forming an ovoid, then a circular opening, as the fetal head crowns.
- The perineum often thins, especially in first-time mothers, potentially resulting in spontaneous lacerations.
- When the fetal head has distended the vulva and perineum to 5cm or more, a gloved hand can be used to support the perineum while another hand guides the fetal head, controlling the delivery process. Slow delivery of the head can decrease lacerations.
Delivery
- In delivering the head, the fetal head rotates posteriorly with its face moving toward the maternal anus. This external rotation occurs to accommodate the bi-acromial (transverse thorax) diameter of the infant into the pelvis.
- Two hands grasp the sides of the head, and gentle downward traction is applied until the anterior shoulder appears under the pubic arch and then posterior shoulder is delivered with an upward movement.
Shoulder Dystocia
- Shoulder dystocia occurs when, after the baby's head delivery, the anterior shoulder can't pass through the maternal pelvis. The posterior shoulder can also get impacted.
- This is an obstetric emergency.
- Risk factors include macrosomia (large baby), gestational diabetes, maternal obesity, short stature, and previous shoulder dystocia.
- Clinical signs include prolonged second stage of labor, fetal distress, difficult delivery of the shoulder, and inability to rotate the baby's shoulder. Treatments may include McRoberts maneuver, suprapubic pressure and/or other maneuvers.
Breech Presentation
- Complete breech: Buttocks first, legs flexed at knees, feet near buttocks
- Frank breech: Buttocks first, legs extended, feet near the head
- Footling breech: One or both feet first, likely delivered before rest of body
Extraction of the Fetus
- Procedures vary depending on the type of breech presentation (complete, frank, or footling).
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Description
This quiz covers the stages of normal labor, including cardinal movements and intrapartum periods. It details the phases of labor from the onset of contractions to the delivery of the placenta, highlighting key management practices. Test your understanding of the normal birthing process and related medical interventions.
