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Questions and Answers
The fetal reference point during the journey through the pelvis is the ischial spine.
The fetal reference point during the journey through the pelvis is the ischial spine.
False
A transverse lie refers to the relationship between the fetal longitudinal axis and that of the mother.
A transverse lie refers to the relationship between the fetal longitudinal axis and that of the mother.
True
Cephalic presentation is a type of malpresentation.
Cephalic presentation is a type of malpresentation.
False
A breech presentation is a type of malpresentation.
A breech presentation is a type of malpresentation.
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Normal labor is defined as uterine contractions that result in rapid dilation and effacement of the cervix.
Normal labor is defined as uterine contractions that result in rapid dilation and effacement of the cervix.
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Episiotomy is a type of intervention that is excluded in the definition of normal labor.
Episiotomy is a type of intervention that is excluded in the definition of normal labor.
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Abnormal labor is defined as uterine contractions that result in rapid dilation and effacement of the cervix.
Abnormal labor is defined as uterine contractions that result in rapid dilation and effacement of the cervix.
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Dystocia of labor is defined as a normal labor.
Dystocia of labor is defined as a normal labor.
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The passage of a twin fetus is an example of normal labor.
The passage of a twin fetus is an example of normal labor.
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Time limits and progress milestones have been identified that define abnormal labor.
Time limits and progress milestones have been identified that define abnormal labor.
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The latent phase of labor is characterized by rapid cervical change of at least 1 cm dilation per hour.
The latent phase of labor is characterized by rapid cervical change of at least 1 cm dilation per hour.
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The first stage of labor lasts for 12 hours in multiparas.
The first stage of labor lasts for 12 hours in multiparas.
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The third stage of labor begins with the onset of labor pain and ends with the expulsion of the fetus.
The third stage of labor begins with the onset of labor pain and ends with the expulsion of the fetus.
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Uterine retractions result in complete relaxation of muscle fibers after each contraction.
Uterine retractions result in complete relaxation of muscle fibers after each contraction.
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The rate of cervical dilatation is 1.5 cm/hour in primiparas.
The rate of cervical dilatation is 1.5 cm/hour in primiparas.
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The duration of the second stage of labor is 2 hours in multiparas.
The duration of the second stage of labor is 2 hours in multiparas.
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The fetal head descends along the obstetrics pelvic axis during labor.
The fetal head descends along the obstetrics pelvic axis during labor.
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The passive phase of labor occurs from complete cervical dilation to onset of active maternal expulsive efforts.
The passive phase of labor occurs from complete cervical dilation to onset of active maternal expulsive efforts.
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The third stage of labor lasts for 1 hour in both primiparas and multiparas.
The third stage of labor lasts for 1 hour in both primiparas and multiparas.
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Maternal pushing during labor is assisted by the abdominal and pelvic muscles.
Maternal pushing during labor is assisted by the abdominal and pelvic muscles.
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Cephalopelvic disproportion (CPD) is a type of obstructed labor that occurs due to hormonal imbalance.
Cephalopelvic disproportion (CPD) is a type of obstructed labor that occurs due to hormonal imbalance.
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A prolonged latent phase of labor is diagnosed when it exceeds 20 hours in multi-parous women.
A prolonged latent phase of labor is diagnosed when it exceeds 20 hours in multi-parous women.
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Protraction disorder in the first stage of labor is characterized by a rapid rate of cervical dilatation.
Protraction disorder in the first stage of labor is characterized by a rapid rate of cervical dilatation.
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Arrest disorder in the first stage of labor is diagnosed when the cervical dilatation rate is less than 1.2 cm/hour in multi-parous women.
Arrest disorder in the first stage of labor is diagnosed when the cervical dilatation rate is less than 1.2 cm/hour in multi-parous women.
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A woman with a second stage of labor exceeding 2 hours is always considered to have a prolonged second stage.
A woman with a second stage of labor exceeding 2 hours is always considered to have a prolonged second stage.
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Kegel's exercise is a type of pelvic-floor exercise that can help prevent obstructed labor.
Kegel's exercise is a type of pelvic-floor exercise that can help prevent obstructed labor.
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Prolonged third stage of labor is diagnosed when the placenta is undelivered within 15 minutes.
Prolonged third stage of labor is diagnosed when the placenta is undelivered within 15 minutes.
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Obstructed labor is a type of labor that is caused by a hormone imbalance.
Obstructed labor is a type of labor that is caused by a hormone imbalance.
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Arrest disorder in the first stage of labor is characterized by a rapid rate of cervical dilatation.
Arrest disorder in the first stage of labor is characterized by a rapid rate of cervical dilatation.
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Kegel's exercise can take up to 6 months to begin to have an effect.
Kegel's exercise can take up to 6 months to begin to have an effect.
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Study Notes
Definition of Labor
- Labor is a physiologic process where the female genital organs work to expel the products of conception (fetus, membranes, umbilical cord, and placenta) out of the uterus through the vagina.
- It involves a series of events to achieve this goal.
Stages of Labor
- First stage: from onset of regular contractions to complete cervical dilation.
- Latent phase: gradual cervical change (up to 4 cm dilatation).
- Active phase: rapid cervical change (at least 1 cm dilatation/hour).
- Passive phase: from complete cervical dilation to onset of active maternal expulsive efforts.
- Second stage: from complete cervical dilation to expulsion of the fetus.
- Active phase: from beginning of active maternal expulsive efforts to expulsion of the fetus.
- Third stage: from expulsion of the fetus to expulsion of the placenta.
- Duration: approximately 30 minutes in both primipara (PG) and multipara (MP).
1st Stage of Labor
- Onset: start of labor pain.
- Offset: full cervical dilation.
- Phases:
- Latent: up to 4 cm.
- Active: from 4 cm to full cervical dilation.
- Rate of dilation:
- Primipara (PG): 1.2 cm/hour.
- Multipara (MP): 1.5 cm/hour.
- Duration:
- Primipara (PG): 12 hours.
- Multipara (MP): 6 hours.
2nd Stage of Labor (Delivery)
- Onset: full cervical dilation.
- Offset: fetal delivery.
- Duration:
- Primipara (PG): 2 hours.
- Multipara (MP): 1 hour.
3rd Stage of Labor
- Onset: fetal delivery.
- Offset: delivery of the afterbirth (placenta + cord + membranes).
- Duration: approximately 30 minutes in both primipara (PG) and multipara (MP).
Power and Passages
- Uterine contractions and retractions:
- Contraction: temporary shortening of muscle fibers.
- Retraction: shortening of muscle fibers with permanent shortening.
- As a result of uterine contractions:
- Dilatation of cervix.
- Descent of fetus and delivery.
- Delivery of placenta.
- Stoppage of postpartum bleeding.
- Additional force: maternal pushing (abdominal and diaphragmatic muscles).
Fetal Presentation
- Cephalic: head first.
- Breech: feet or buttocks.
- Shoulder: back or abdomen.
- Malpresentation: any fetal presentation other than cephalic.
Normal Labor
- Passage of a single, term, viable fetus of average weight.
- Cephalic presentation through the natural passages.
- Within average duration from spontaneous onset of uterine contractions.
- With no interventions (except episiotomy) and no complications to the mother or fetus.
Abnormal Labor
- Failure to meet time limits and progress milestones of normal labor.
- Terms that are often used: dystocia, dysfunctional labor, failure to progress, and cephalopelvic disproportion (CPD).
- Obstructed labor: failure of fetal delivery in spite of strong uterine contractions due to mechanical obstruction.
Types of Abnormal Labor
- Prolonged latent phase: ≥20 hours for the Nuli Para and ≥14 hours for the Multi Para.
- First stage abnormalities:
- Protraction disorder: slow rate of cervical dilatation.
- Arrest disorder: no cervical change for 1 hour despite adequate contractions.
- Second stage abnormalities:
- Protraction disorder: slow rate of descent.
- Arrest disorder: no progress (descent, rotation) for 1 hour.
- Prolonged third stage: undelivered placenta > 30 minutes.
Kegel's Exercise
- Pelvic-floor exercise: repeatedly contracting and relaxing the muscles that form part of the pelvic floor.
- The exercise can be performed many times a day, for several minutes at a time, but takes 1-3 months to begin to have an effect.
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Description
Learn about the definition of labor, its physiologic process and stages, including the latent and active phases of the first stage.