Obstetrics: Pelvic Measurements and Labor Signs

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Questions and Answers

What measurement is used to estimate the obstetric conjugate?

Transverse diameter minus 1 cm

Diagonal conjugate minus 1.5 to 2 cm (correct)

Transverse diameter plus 1 cm

Diagonal conjugate minus 2.5 cm

Which diameter is calculated between the ischial spines?

Anteroposterior diameter

Pelvic inlet diameter

Transverse diameter (correct)

Obstetric conjugate

What happens during lightening in relation to the fetal head?

It is fully engaged in the pelvic inlet

It descends into the pelvic brim (correct)

It rotates 90 degrees

It moves upward against the diaphragm

What causes the loss of weight in a pregnant woman one to two days before labor onset?

Decrease in progesterone and fluid excretion Signup and view all the answers

What is a characteristic of Braxton Hicks contractions?

Painless and intermittent Signup and view all the answers

How is the cervix described as it ripens before labor?

Butter-soft Signup and view all the answers

What does a green staining of amniotic fluid potentially indicate?

Fetal distress Signup and view all the answers

What physiological change is referred to as 'nesting behavior' in pregnant women?

Sudden burst of energy and activity Signup and view all the answers

What does the term 'show' refer to during labor?

A blood-tinged mucus discharge Signup and view all the answers

Which of the following is TRUE regarding the phases of uterine contractions?

Acme marks the height of the contraction Signup and view all the answers

What is the key difference between false labor pains and true labor pains?

True labor pains lead to cervical changes Signup and view all the answers

During which phase does the cervix become 'paper thin'?

Effacement phase Signup and view all the answers

How is dilatation of the cervix measured?

From 0 to 10 cm full dilatation Signup and view all the answers

When does effacement typically occur in primigravidas compared to multigravidas?

Effacement occurs before dilatation in primigravidas Signup and view all the answers

What happens to false labor pains when the woman ambulates?

They often disappear Signup and view all the answers

What primarily differentiates true labor from false labor in terms of contraction patterns?

True labor contractions become regular over time Signup and view all the answers

What condition is indicated by a full bladder that displaces the uterus?

Uterine atony Signup and view all the answers

Which voiding pattern should be recorded during bladder assessment?

Volume and times voided Signup and view all the answers

What should be the position of the mother after delivery to prevent dizziness?

Flat on bed without pillows Signup and view all the answers

What is the normal expectation for protein levels in urine during examination?

Negative or trace amounts Signup and view all the answers

What characterizes precipitate delivery?

Labor completed in less than 3 hours. Signup and view all the answers

What does a high level of glucose in urine potentially indicate?

Gestational diabetes Signup and view all the answers

What is the minimum duration of the first stage of labor for primigravidas?

10-14 hours. Signup and view all the answers

Which of the following best describes the role of ketones in urine assessment?

Byproducts of fatty acid breakdown Signup and view all the answers

Which phase of the first stage of labor is characterized by cervical dilation of 0-4 cm?

Latent Phase. Signup and view all the answers

How does the recovery phase after childbirth typically last?

1-2 hours. Signup and view all the answers

Which step is essential before conducting a physical examination of a laboring woman?

Emptying the bladder Signup and view all the answers

What is the typical total duration of the labor stages for multigravidas?

8 hours. Signup and view all the answers

What should be the primary focus during an abdominal examination of a laboring woman?

Assessing fetal size and position Signup and view all the answers

At what dilation does the Active Phase of the first stage of labor begin?

2-3 cm. Signup and view all the answers

What is the duration of the second stage of labor for multigravidas?

30-45 minutes. Signup and view all the answers

Which option correctly describes the intensity and intervals of the Active Phase?

Moderate to strong intensity with a 5-minute interval. Signup and view all the answers

What is a potential consequence of unnecessary bearing down during contractions in labor?

Maternal exhaustion Signup and view all the answers

Which position is recommended to help a woman avoid Supine Hypotensive Syndrome during labor?

Sim's position Signup and view all the answers

How frequently should uterine contractions be monitored during the active phase of labor?

Every 30 minutes Signup and view all the answers

When should a woman in labor seek hospital admission based on her contractions?

Every 5-10 minutes Signup and view all the answers

What is the duration of a contraction measured from?

Start of one contraction to end of that same contraction Signup and view all the answers

During uterine contractions, what happens to blood flow to the placenta?

Ceases completely Signup and view all the answers

When should blood pressure and fetal heart rate be taken during labor?

In between contractions Signup and view all the answers

What is a risk of prolonged and sustained uterine contractions?

Uterine rupture Signup and view all the answers

Study Notes

Pelvic Measurements

Obstetric Conjugate: Shortest diameter of the pelvic inlet; estimated by subtracting 1.5 to 2 cm from the diagonal conjugate. Measures 10 cm or more.
Transverse Diameter: Line between the points furthest from the ileopectineal line; measures 13 cm.
Pelvic Outlet:
- Anteroposterior: Lower border of the symphysis pubis to the sacrococcygeal points. Diameter: 13 cm.
- Transverse Diameter: Between the 2 ischial spines. Diameter: 10-11 cm. The narrower diameter is more important than the wider diameter.

Signs of Labor

Lightening: Settling of the fetal head into the pelvic brim, occurs 2-3 weeks before labor onset.
Loss of Weight: 2-3 lbs weight loss due to loss of appetite and decrease in progesterone levels.
Increased Activity: Sudden burst of energy believed to be due to increase in epinephrine.
Braxton Hicks Contractions: Painless, irregular, and intermittent uterine contractions.
Cervical Ripening: Cervix becomes soft.
Rupture of Membranes: Amniotic fluid may leak from the vagina.
Show: Blood-tinged mucus discharged from the vagina due to pressure on cervical capillaries.

True Labor vs. False Labor

True Labor:
- Regular contractions that become predictable.
- Pain felt in the lower back and sweeps around to the abdomen.
- Increase in duration, frequency, and intensity.
- Continued pain regardless of activity.
- Cervical changes.
False Labor:
- Irregular contractions.
- Pain confined to the abdomen.
- No change in duration, frequency, or intensity.
- Pain disappears with ambulation.
- No cervical changes.

Dilatation and Effacement

Dilatation: The process of the cervix opening from a few millimeters to 10 cm.
Effacement: Thinning and shortening of the cervical canal.

Uterine Changes in Labor

Upper Uterine Segment: Portion from the isthmus to the fundus.
Lower Uterine Segment: Portion from the isthmus to the cervix.

Stages of Labor

Stage I: Cervical Dilatation
- Primigravidas (first-time mothers): Average 12.5 hours
- Multigravidas (mothers with previous births): Average 7 hours, 20 minutes
Stage II: Fetal Expulsion
- Primigravidas: Average 1.5 hours
- Multigravidas: Average 30-45 minutes
Stage III: Placental Delivery
- Primigravidas and Multigravidas: Average 10 minutes
Stage IV: Recovery/Immediate Postpartum
- Average 1-2 hours

Phases of Stage I Labor

Latent Phase: 0-4 cm dilated, 30-45 second contractions every 15 minutes, mild intensity.
Active Phase: 4-8 cm dilated, 45-60 second contractions every 5 minutes, moderate to strong intensity.
Transition Phase: 8-10 cm dilated, 60-90 second contractions every 2-3 minutes, very strong intensity.

Nursing Interventions during Stage I Labor

Breathing Technique: Encourage abdominal breathing.
Position: Encourage Sims position to promote relaxation and prevent Supine Hypotensive Syndrome.
Contraction Monitoring: Monitor frequency, duration, and intensity every hour during latent phase and every 30 minutes during active phase.
Vital Signs: Monitor blood pressure and fetal heart rate every hour during latent phase and every 30 minutes during active phase.
Bladder Assessment: Encourage voiding every 2-3 hours to prevent uterine atony.

Urinary Tests during Intrapartum

pH: Normal levels indicate proper hydration; high levels can mean dehydration.
Protein: Normal levels are negative; presence may indicate urinary tract infection, kidney infection, or preeclampsia.
Glucose: Normal levels are negative; presence may indicate high blood sugar, gestational diabetes, or diabetes mellitus.
Ketones: Normal levels are negative; presence may indicate low blood sugar.

Abdominal Examination

Fundal Height Measurement: Measure the height of the uterus.
Leopold's Maneuvers: Assess fetal size, presentation, and position through palpating the abdomen.

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Description

Explore essential pelvic measurements and signs of labor in obstetrics. This quiz will assess your understanding of important anatomical details and physiological changes that signal the onset of labor. Perfect for students in healthcare or midwifery programs.