Podcast
Questions and Answers
What is the primary initial action to monitor a patient in the first 4 hours postpartum?
What is the primary initial action to monitor a patient in the first 4 hours postpartum?
What complication is indicated by early decelerations in fetal heart rate?
What complication is indicated by early decelerations in fetal heart rate?
What is the appropriate action if there are variable decelerations during labor?
What is the appropriate action if there are variable decelerations during labor?
What should be done to the uterine fundus if clots are present postpartum?
What should be done to the uterine fundus if clots are present postpartum?
Signup and view all the answers
What indicates a critical condition in a laboring patient related to oxygenation?
What indicates a critical condition in a laboring patient related to oxygenation?
Signup and view all the answers
Which type of deceleration is associated with placental insufficiency?
Which type of deceleration is associated with placental insufficiency?
Signup and view all the answers
What is an indication that a patient is not tolerating labor effectively?
What is an indication that a patient is not tolerating labor effectively?
Signup and view all the answers
What critical factor must be monitored in relation to pitocin administration?
What critical factor must be monitored in relation to pitocin administration?
Signup and view all the answers
In the context of labor complications, what does the term 'hypertonic' refer to?
In the context of labor complications, what does the term 'hypertonic' refer to?
Signup and view all the answers
What is a potential consequence of giving oxytocin without appropriate monitoring?
What is a potential consequence of giving oxytocin without appropriate monitoring?
Signup and view all the answers
Study Notes
Normal Labor
- Theories on the onset of labor are not required for the exam.
- Estrogen stimulates uterine muscle softening, stretching, and thinning.
- Progesterone relaxes uterine smooth muscle, preventing contractions.
- Oxytocin and prostaglandins have a role in labor.
- Fetal cortisol increases near term.
- Uterine distention triggers labor.
Types of Labor
- False labor (Braxton Hicks): Irregular contractions, no cervical changes, intensity does not increase.
- True labor: Progressive contractions, cervical changes (effacement and dilation), back pain radiating to the front, rupture of membranes (ROM). Contractions are not easily stopped and occur on a regular interval. Presenting part descends.
- Bloody show usually precedes true labor.
Critical Factors in Labor (Four P's)
- Passage: Pelvic dimensions impact labor. Gynecoid pelvis is the most favorable for vaginal delivery.
- Passenger: Fetal presentation (vertex = head first, breech = buttock/feet first, shoulder), attitude, lie, and station.
- Powers: Uterine contractions (frequency, duration, intensity) and maternal pushing efforts
- Psyche: Psychological state of the laboring woman influences labor.
Fetal Presentation
- Determined by the body part of the fetus that enters the pelvis first.
- Cephalic (head first) is the most common. Different types of cephalic presentations include (vertex, brow, face)
Fetal Lie & Attitude
-
Lie: Relationship of the spine of the fetus to the maternal spine
- Longitudinal: fetal spine parallel to maternal spine (most favorable)
- Transverse: fetal spine at right angle to maternal spine (not favorable).
-
Attitude: Relationship of fetal body parts to each other (Flexion).
- Flexion: General flexion (optimum), and deviations from flexion can create a harder labor.
Fetal Station
- Relationship of the presenting part to maternal ischial spines.
- Negative station means the presenting part is above the ischial spines.
- Positive station means the presenting part is below the ischial spines.
Fetal Position
- Relationship of the presenting part to the maternal pelvis's four quadrants.
Fetal Monitoring:
- External monitoring uses a tocodynamometer and ultrasound to measure frequency, duration, and intensity of contractions.
- Internal monitoring uses an intrauterine pressure catheter (IUPC) to measure intrauterine pressure to measure intensity, and a fetal scalp electrode to measure FHR (more accurate).
Premonitory Signs/Symptoms
- Lightening - fetus descending into pelvis
- Braxton Hicks contractions
- Cervical changes (softening)
- Bloody show
Stages of Labor
-
First stage: Onset of true labor to complete cervical dilation (10 cm)
- Latent phase: early dilation (0-3 cm), contractions mild
- Active phase: dilation continues, contractions increase in frequency, duration, and intensity(4-7 cm)
- Transitional phase: dilation is near completion (8-10 cm), contractions intense.
- Second stage: Complete dilation to delivery of the baby
- Third stage: Delivery of the placenta to separation of the placenta
- Fourth stage: 1-4 hours after delivery, focusing on maternal recovery
Complications
- Preterm Labor: Onset of labor between 20 and 37 completed weeks of pregnancy.
- Premature Rupture of Membranes (PROM): Rupture of membranes prior to the onset of labor.
- Placenta Previa: Placental implantation in the lower uterine segment, potentially covering the cervix.
- Abruptio Placenta: Premature separation of the placenta from the uterine wall.
- Incompetent Cervix: Premature dilation of the cervix, requiring a cerclage (stitch).
- Gestational diabetes: Carbohydrate/glucose intolerance, often requiring increased glucose monitoring and control.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the essential aspects of normal labor, including the scientific theories behind its onset and the differences between false and true labor. Study key factors like the Four P's that influence labor, such as passage, passenger, and psyche. Prepare to evaluate your understanding of these critical concepts and their implications in childbirth.
