5 Questions
What is the purpose of the exam described in the text?
Assessing the status of membranes, fetal presentation, and cervical dilatation
Which sign is a preliminary labor sign caused by the settling of the fetal head into the inlet of the true pelvis?
Lightening
What are the three signs of true labor?
Regular uterine contractions, rupture of membranes, lightening
When does the first stage of labor end?
Full dilatation of the cervix
What occurs in the second stage of labor?
Delivery of the baby
Study Notes
Stages of Labor
- Effacement is the shortening and thinning of the cervical canal, which normally disappears (1-2 cm) due to longitudinal traction from the contracting uterine fundus.
- Palpation is used to determine the degree of thickness; a normal cervix is about 1 inch thick.
- Primigravida effacement occurs before dilatation, whereas multigravida may dilate before effacement.
Dilatation
- Dilatation is the enlargement of the cervical canal from a few millimeters wide to approximately 10 cm to permit passage.
- There are two reasons for dilatation:
- Uterine contractions gradually increase the diameter of the cervical canal lumen by pulling the cervix up.
- Fluid-filled membranes press against the cervix, serving as an opening wedge if intact, and the presenting part of the fetus serves as an opening wedge if ruptured.
- During dilatation, there is an increase in vaginal secretions (show).
- Cervical dilation is estimated by finger width, with 1 finger representing approximately 1.5 cm.
Vaginal Examination
- A fetal heart check and abdominal palpation for fetal position and presentation should always precede the initial vaginal examination.
- The vulva should be carefully inspected for lesions (e.g., abnormalities).
Test your knowledge of labor and delivery terminology with this quiz covering terms such as effacement and dilatation. Learn about the stages of labor and the changes that occur in the cervix during childbirth.
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