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What gestational age is considered to define premature labor?
What gestational age is considered to define premature labor?
Which theory suggests that a decrease in progesterone and an increase in estrogen lead to the onset of labor?
Which theory suggests that a decrease in progesterone and an increase in estrogen lead to the onset of labor?
What hormone's increase is associated with stimulating uterine contractions during labor?
What hormone's increase is associated with stimulating uterine contractions during labor?
Which theory posits that an increase in intra-abdominal pressure initiates labor?
Which theory posits that an increase in intra-abdominal pressure initiates labor?
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What physiological substance promotes cervical ripening in preparation for labor?
What physiological substance promotes cervical ripening in preparation for labor?
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Which factor is NOT part of the 5Ps affecting labor progression?
Which factor is NOT part of the 5Ps affecting labor progression?
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The gradual increase of which hormone during pregnancy peaks in the second stage of labor?
The gradual increase of which hormone during pregnancy peaks in the second stage of labor?
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Which factor does NOT directly affect the mother's ability to progress in labor?
Which factor does NOT directly affect the mother's ability to progress in labor?
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Which part of the fetal head is known for overlapping at the suture line to facilitate delivery?
Which part of the fetal head is known for overlapping at the suture line to facilitate delivery?
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What is the significance of the anterior fontanelle in the fetal skull?
What is the significance of the anterior fontanelle in the fetal skull?
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Which factor does NOT affect the progress of labor?
Which factor does NOT affect the progress of labor?
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In which type of delivery does engagement occur during labor?
In which type of delivery does engagement occur during labor?
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What term describes the relationship of body parts of the fetus?
What term describes the relationship of body parts of the fetus?
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What does fetal engagement refer to?
What does fetal engagement refer to?
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Which statement about fetal sutures is incorrect?
Which statement about fetal sutures is incorrect?
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Which structure facilitates the assessment of fetal engagement during examination?
Which structure facilitates the assessment of fetal engagement during examination?
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What is the site of pain during true labor pains?
What is the site of pain during true labor pains?
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Which phase of uterine contraction is characterized by maximal pressure?
Which phase of uterine contraction is characterized by maximal pressure?
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What happens to cervical dilatation during true labor?
What happens to cervical dilatation during true labor?
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What term describes the time between the start of one contraction to the start of the next?
What term describes the time between the start of one contraction to the start of the next?
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Which of the following is a characteristic of false labor pains?
Which of the following is a characteristic of false labor pains?
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During which phase of uterine contraction does intra-uterine pressure start to increase?
During which phase of uterine contraction does intra-uterine pressure start to increase?
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What is the primary role of uterine contractions during labor?
What is the primary role of uterine contractions during labor?
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What is the range of pressure (in mmHg) at which pain is typically felt during uterine contractions?
What is the range of pressure (in mmHg) at which pain is typically felt during uterine contractions?
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What is the definition of normal labor?
What is the definition of normal labor?
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What characterizes prolonged labor?
What characterizes prolonged labor?
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What is one of the factors that affects labor as mentioned in the content?
What is one of the factors that affects labor as mentioned in the content?
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Which theory relates to the onset of labor?
Which theory relates to the onset of labor?
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Which of the following signifies true labor?
Which of the following signifies true labor?
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What is the duration of labor for a primigravida?
What is the duration of labor for a primigravida?
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What distinguishes precipitate labor from normal labor?
What distinguishes precipitate labor from normal labor?
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Which stage of labor involves signs of the placental separation?
Which stage of labor involves signs of the placental separation?
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What is the duration of the latent phase of the first stage for a primipara?
What is the duration of the latent phase of the first stage for a primipara?
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How much cervical dilation is expected during the transitional phase?
How much cervical dilation is expected during the transitional phase?
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What is the frequency of uterine contractions during the active phase?
What is the frequency of uterine contractions during the active phase?
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What maternal behavior is typically observed during the active phase?
What maternal behavior is typically observed during the active phase?
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How often do uterine contractions occur in the second stage of labor?
How often do uterine contractions occur in the second stage of labor?
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What is the expected duration of contractions in the second stage of labor?
What is the expected duration of contractions in the second stage of labor?
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What is a sign that the bag of water should have ruptured by the end of the first stage?
What is a sign that the bag of water should have ruptured by the end of the first stage?
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Which type of maternal behavior indicates the transitional phase of labor?
Which type of maternal behavior indicates the transitional phase of labor?
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What occurs during the extension of the fetal head as it reaches the perineum for birth?
What occurs during the extension of the fetal head as it reaches the perineum for birth?
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What is the purpose of external rotation of the fetal head after birth?
What is the purpose of external rotation of the fetal head after birth?
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Which sequence describes the order of emergence of the fetal head during birth?
Which sequence describes the order of emergence of the fetal head during birth?
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What does internal rotation of the fetal head accomplish?
What does internal rotation of the fetal head accomplish?
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During which phase does the expulsion of the fetal body primarily occur?
During which phase does the expulsion of the fetal body primarily occur?
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What initiates the external rotation of the fetal head post-delivery?
What initiates the external rotation of the fetal head post-delivery?
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What is the anteroposterior diameter in relation to fetal delivery?
What is the anteroposterior diameter in relation to fetal delivery?
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What marks the beginning of the third stage of labor?
What marks the beginning of the third stage of labor?
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Study Notes
Physiology of Normal Labor
- Labor: The process of regular uterine contractions, cervical effacement and dilation, resulting in the delivery of a viable fetus and placenta.
- Viability: A reasonable chance of the fetus to live outside the uterus, usually at 28 weeks of pregnancy.
- Normal Labor: A complete and spontaneous delivery of a full-term, single, viable fetus through the natural birth canal within 24 hours of true labor pain onset, without assistance or complications for the mother or newborn.
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Duration of Normal Labor:
- Primigravida (first pregnancy): Typically 12-18 hours.
- Multigravida (subsequent pregnancies): Usually shorter, around 6-10 hours.
- Prolonged Labor: Labor lasting more than 24 hours.
- Precipitate Labor: Labor lasting less than 3 hours.
- Premature Labor: Results in a premature fetus, occurring between 28-37 weeks of gestation.
Content Outline
- Definition of terms (labor, viability, normal labor, etc.)
- Theories of labor onset (progesterone withdrawal, prostaglandin production, uterine distention, placental ischemia, oxytocin stimulation)
- Factors affecting labor (5Ps: Passenger, Passage, Power, Position, Psyche)
- Prodromal stage (premonitory signs of labor)
- Signs of true labor (differentiation from false labor pains)
- Nature of uterine contraction (phases: increment, acme, decrement)
- Stages of labor (first stage, second stage, third stage, fourth stage)
- Phases of the First Stage (latent, active, transitional)
- Signs of the Second Stage of Labor
- Mechanism of labor (descent, flexion, internal rotation, extension, external rotation, expulsion)
- Signs of Placental Separation
- Mechanisms of placental separation (Schultze's and Duncan's mechanisms)
- Fourth stage of labor (restorative stage)
Factors Affecting Labor (5Ps)
- Passenger: Fetus, placenta, membranes, umbilical cord, blood, amniotic fluid, fetal head (size, molding, attitude, lie, presentation, position, station, engagement)
- Passage: Birth canal (bony pelvis)
- Power: Uterine contractions (frequency, duration, intensity)
- Position: Maternal position during labor.
- Psyche: Maternal psychological response (emotional state, anxiety, stress, fear, pain tolerance)
Signs of Normal Labor
-
Premonitory Signs:
- Lightening (uterine descent)
- Frequency of urination
- Cervical effacement (shortening and thinning of the cervix)
- Cervical ripening and softening.
- Braxton Hicks contractions
- Bloody show
- Rupture of membranes (water breaking)
-
True Labor Signs:
- Progressive cervical dilation
- Regular uterine contractions with increasing frequency, duration, and intensity
- Discomfort that includes lower back pain; abdominal pain, or pain in the abdomen and lower back.
Mechanism of Labor
- Descent: The progress of the presenting part through the pelvis (measured by the station).
- Flexion: The chin of the fetal head flexes toward the chest to encounter resistance.
- Internal Rotation: The fetal head rotates as it descends and engages.
- Extension: The head extends as it passes through the pelvic outlet.
- External Rotation (Restitution): The head rotates to its original position, allowing the shoulders to rotate.
- Expulsion: The complete birth of the baby.
Placental Separation
- Two mechanisms: Schultze's method and Duncan's method.
Stages of Labor
- First Stage: Cervical dilatation and effacement (latent phase, active phase, transitional phase).
- Second Stage: Expulsion of the fetus.
- Third Stage: Delivery of the placenta.
- Fourth Stage: Recovery (1-2 hours)
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Description
Explore the essential concepts related to the physiology of normal labor, including definitions of labor, viability, and normal labor. Learn about the durations of labor for primigravida and multigravida pregnancies and the distinctions among prolonged, precipitate, and premature labor.
