Stage One Labor Overview
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Questions and Answers

What is the recommended course of action for a pregnant woman with premature rupture of membranes (PROM) at 32 weeks gestation?

  • Immediate induction of labor to prevent infection.
  • Cesarean delivery to prevent fetal distress.
  • Administration of antibiotics and corticosteroids. (correct)
  • Bed rest and close monitoring of maternal and fetal health.

    • Which of the following is a potential complication associated with post-term pregnancy?

  • Gestational diabetes.
  • Preterm labor.
  • Meconium aspiration syndrome. (correct)
  • Premature rupture of membranes.

    • Which of the following is NOT a cause of dystocia?

  • Hypertonic uterine dysfunction in the latent phase of labor.
  • Cephalopelvic disproportion.
  • Placental abruption. (correct)
  • Fetal malpresentation.

    • What is the primary purpose of administering antenatal glucocorticoids to a pregnant woman at 30 weeks gestation?

    <p>To stimulate fetal lung maturity. (B)</p> Signup and view all the answers

    Which of the following is a characteristic of precipitous labor?

    <p>Labor lasting less than 3 hours. (C)</p> Signup and view all the answers

    Which of these is NOT a sign that a baby may be experiencing distress during labor?

    <p>Accelerations (D)</p> Signup and view all the answers

    According to the document, what is the most common cause of spontaneous preterm birth?

    <p>Infection (C)</p> Signup and view all the answers

    If a baby is experiencing variable decelerations during labor, what is the appropriate intervention?

    <p>Reposition the mother to relieve pressure on the cord (B)</p> Signup and view all the answers

    What does a PAR score assess in the postpartum period?

    <p>Maternal vital signs, activity level, and consciousness (C)</p> Signup and view all the answers

    What is the timeframe for the fourth stage of labor?

    <p>First 1-2 hours after delivery (C)</p> Signup and view all the answers

    Which of the following is NOT a method of stimulating a baby experiencing late decelerations?

    <p>Administering a tocolytic (C)</p> Signup and view all the answers

    Which category of fetal heart rate patterns is considered 'BAD' during labor?

    <p>Category 3 (C)</p> Signup and view all the answers

    What is the definition of a preterm birth?

    <p>Birth before 37 weeks of gestation (B)</p> Signup and view all the answers

    What is the significance of a cervical length greater than 30mm in the second and third trimesters?

    <p>It indicates a decreased risk of preterm labor (C)</p> Signup and view all the answers

    What is the difference between preterm labor and low birth weight?

    <p>Preterm labor is a shorter gestation than low birth weight (D)</p> Signup and view all the answers

    What is the term for a labor that has started but is not progressing as expected?

    <p>Augmentation (B)</p> Signup and view all the answers

    Which of the following is NOT a risk factor for cord compression?

    <p>Normal fetal heart rate (B)</p> Signup and view all the answers

    What is the name of the maneuver used to open the pelvis by pulling the mother's legs back towards her head?

    <p>McRoberts maneuver (B)</p> Signup and view all the answers

    Which of the following is a common complication of obesity during pregnancy?

    <p>Increased risk of blood clots (A)</p> Signup and view all the answers

    What is the term for a trial of labor after a previous cesarean section?

    <p>TOLAC (B)</p> Signup and view all the answers

    What is the medical term for severe nausea and vomiting during pregnancy?

    <p>Hyperemesis gravidarum (D)</p> Signup and view all the answers

    Which of the following is a potential complication of a cesarean section?

    <p>Uterine rupture (D)</p> Signup and view all the answers

    What is the term for the thin, cheesy substance that coats the baby's skin in utero?

    <p>Vernix (B)</p> Signup and view all the answers

    Which of the following is a chemical method of cervical ripening?

    <p>Cytotec (A)</p> Signup and view all the answers

    What is the term for a birth that occurs after the baby's head has emerged but the shoulder cannot pass through the pubic bone?

    <p>Shoulder dystocia (A)</p> Signup and view all the answers

    What is the dilation range for the active phase of labor?

    <p>5-10 cm (B)</p> Signup and view all the answers

    Which assessment is NOT part of the admission to the labor unit?

    <p>Comfort level assessment (B)</p> Signup and view all the answers

    What does the acronym COCA stand for in ROM assessment?

    <p>Consistency, Odor, Color, Amount (C)</p> Signup and view all the answers

    Which laboratory test is critical to assess for potential infection during labor?

    <p>CBC for WBC count (C)</p> Signup and view all the answers

    What is the preferred birth position as stated for the doctor?

    <p>Lithotomy (C)</p> Signup and view all the answers

    Which of the following describes a third-degree tear during childbirth?

    <p>Involves the external sphincter (A)</p> Signup and view all the answers

    What is the typical duration for the third stage of labor until placenta expulsion?

    <p>15 minutes (D)</p> Signup and view all the answers

    What should be monitored closely after birth to check for the detachment of the placenta?

    <p>Gush of blood and cord lengthening (A)</p> Signup and view all the answers

    Flashcards

    Latent Phase

    0-5 cm dilation before active labor begins.

    Active Phase

    5-10 cm cervical dilation where labor intensity increases.

    ROM Assessment

    Evaluates if rupture of membranes has occurred, checking COCA.

    Ferguson Reflex

    An involuntary urge to push during childbirth.

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    Episiotomy

    Intentional cut made to prevent uncontrolled tearing during delivery.

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    Tears Classification

    Different levels of perineal tearing from childbirth: 1st to 4th degree.

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    Stage Three

    Shortest stage from birth to placenta expulsion, usually under 30 minutes.

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    Labor Positioning

    Adjusting the mother's position frequently to aid delivery.

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    Tocolytics

    Medications that relax smooth muscle to reduce contractions.

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    Antenatal glucocorticoids

    Steroids given to mature fetal lungs and reduce respiratory risks.

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    Chorioamnionitis

    Infection of the amniotic sac, often leading to preterm labor.

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    Dystocia

    Abnormal labor progression; most common cause for C-sections.

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    PPROM

    Preterm premature rupture of membranes before labor begins.

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    Inspect Placenta

    Check to ensure all parts of the placenta are expelled after birth.

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    Recovery Stage

    First 1-2 hours postpartum to assess mother’s stability.

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    Par Score

    Assessment of activity, respiration, blood pressure, level of consciousness, and color.

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    Fetal Heart Rate (FHR) Categories

    Classification of fetal heart patterns into three categories.

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    Category 1 FHR

    Normal fetal heart rate of 110-160 beats/minute with moderate variability.

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    Late Deceleration

    Fetal heart decline occurring after a contraction due to placental insufficiency.

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    Preterm Labor

    Contractions and cervical changes occurring between 20 to 36+6 weeks of gestation.

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    Very Preterm

    Birth that occurs before 32 weeks of gestation.

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    Fetal Fibronectin Test

    A test used to predict the likelihood of preterm labor.

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    Causes of Low Birth Weight

    Born under 2500 grams, often due to conditions like IUGR.

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    Positional Dystocia

    Altered contractions due to the mother's position.

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    Psychologic Dystocia

    Labor stops due to maternal stress and hormone release.

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    Bishop Score

    Evaluation of a cervix's readiness for labor induction.

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    External Version

    Procedure to reposition the baby outside the womb.

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    VBAC

    Vaginal birth after a previous Cesarean section.

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    Shoulder Dystocia

    Condition where the baby's shoulder is stuck during delivery.

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    Prolapsed Cord

    Umbilical cord is below the presenting part during labor.

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    Uterine Rupture

    Separation of the uterine wall, often due to previous scars.

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    Hyperemesis Gravidarum

    Severe nausea and vomiting in pregnancy.

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    Oxytocin

    Hormone used to induce or augment labor contractions.

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    Study Notes

    Stage One Labor

    • Latent phase: Cervical dilation from 0-5 cm
    • Active phase: Cervical dilation from 5-10 cm (ending in birth)
    • Admission to labor unit: Includes prenatal data, complications, abuse, and cultural/language differences.
    • Assessment: Leopold's maneuver (assessing baby position), fetal heart rate & pattern, contractions, and cervical checks.
    • ROM assessment: Color, odor, consistency, and amount. Includes lab tests.
    • CBC: Checks white blood cells (infection), hematocrit, hemoglobin, and platelet count (clotting factors, HELLP syndrome).
    • HIV and titers: Checking for HIV, rubella immunity, and syphilis (harmful to baby).
    • Type and screen: Blood type and screen (for potential complications)
    • GBS (group B strep): Antibiotic treatment if positive.
    • Nutrition: Oral and IV fluid intake
    • Elimination: Monitoring urination (at least every 2 hours). Intermittent catheter or Foley catheter as needed.
    • Positioning: Frequent repositioning of the mother.

    Stage Two Labor

    • Latent phase: Labor in preparation
    • Active phase: Active pushing or bearing down.
    • Ferguson reflex: Ejection reflex, cannot control pushing.
    • Positioning: Commonly lithotomy position preferred.
    • Bearing down: Valsalva maneuver (sneezing, coughing, pushing).
    • Monitoring: Continuous fetal heart rate monitoring.

    Stage Three Labor

    • Quickest stage: Shortest stage, from birth to expulsion of the placenta.
    • Intervention may be needed at 30 minutes after birth to assist with placenta expulsion
    • Inspection of placenta: Assure all parts have expelled and prevent retained pieces.

    Stage Four Labor

    • Recovery: A period of 1-2 hours, post-birth.
    • Assessments: For blood loss, vital signs, and bonding between parent and baby
    • Post-partum care: Facilitate breastfeeding/bonding.
    • Post-anesthesia care:
    • Monitoring during recovery: Activity, respiration rate, blood pressure, and color

    Fetal Assessment During Labor

    • Fetal heart rate (FHR) patterns: Baseline, accelerations, decelerations, and variability.
    • Category 1: Desirable patterns
    • Category 2: Uncertain, further observation required
    • Category 3: Concerns requiring intervention
    • Recurrent late decelerations: Signals placental insufficiency.
    • Bradycardia: Slow heart rate
    • Sinusoidal pattern: Irregular FHR pattern needing immediate intervention.

    Other Interventions and Considerations

    • Equipment Setup: Equipment in case of certain emergencies.
    • Birth: Crowning, nuchal cord, episiotomy.
    • Post-birth care: Skin-to-skin contact, lotus birth.
    • Stage 3 interventions: Stimulating baby, vibroacoustic stimulation, amnioinfusion, tocolytic therapy.
    • Complications: Preterm labor and birth (20-36+6 weeks of gestation), low birth weight (<2500g), preterm births.
    • Cervical length: >30mm in 2nd & 3rd trimesters correlates with less likelyhood of preterm birth.
    • Fetal fibronectin test: Predicts likelihood of labor within 2 weeks.
    • Bed rest: Not supported unless in extreme cases
    • Tocolytics: Medications to relax the uterus muscles
    • Antenatal glucocorticoids: For lung maturity in premature births
    • Premature ROM (PROM): Rupture of membranes before labor.
    • Preterm premature rupture of membranes (PPROM): Rupture of membranes before labor.
    • Chorioamnionitis: Infection of the fetal membranes and amniotic sac.
    • Post-term pregnancies: Are pregnancies beyond 42 weeks. High risk of stillbirth.
    • Dystocia: Difficult labor, including obstructions (like bony pelvis).
    • Pelvic dystocia: Pelvis size is a problem.
    • Positional dystocia: Maternal positional issues causing difficulty.
    • Psychologic dystocia: Mother being stressed.
    • Obesity: High BMI increasing risk of complications.
    • Fetal monitoring: Continuous and intermittent monitoring for fetal wellness.
    • Positioning: Maintaining proper positions to aid in labor progress

    Procedures and Assessments

    • Bishop score: Evaluating cervical readiness for labor induction.
    • Cervical ripening methods.
    • Amniotomy.
    • Oxytocin.
    • Augmentation.
    • Operative vaginal birth.
    • Forceps delivery.
    • Vacuum extraction.
    • Assessments of the baby (e.g., for brain bleeding/head injuries).
    • Section.
    • VBAC (Vaginal birth after cesarean): 60-80% success, but with complications.
    • TOLAC (Trial of labor after cesarean): Labor attempt after cesarean.
    • Scheduled/Elective cesarean sections.
    • Unplanned cesarean section.
    • Forced-choice cesarean section (labor continued).
    • Incission type (vertical vs. horizontal)
    • Skin vs uterine incisions: Different approaches for incisions during Cesarean delivery.

    Emergencies and Complications

    • Ob emergency issues: Meconium stained fluid, stress, premature birth, and labor complications like uterine rupture.
    • Shoulder dystocia.
    • Fetus problems (Asphyxia, brachial plexus damage, Fractures)
    • Prolapsed cord.
    • Amniotic fluid embolism (AFE).
    • Risk factors for all of these emergencies
    • Resolution of issues (Weight loss, dehydration, etc)

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    Description

    This quiz covers essential aspects of Stage One Labor, including phases of cervical dilation, assessments, and monitoring protocols. You'll gain insights into important procedures such as ROM assessment, CBC tests, and nutritional considerations during labor. Test your knowledge on the critical elements of labor management.

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