ATI Engage: Progression of Uncomplicated Labor

Practice vocabulary flashcards regarding the progression of uncomplicated labor, covering fetal factors, maternal adaptations, first stage of labor, and fetal monitoring based on ATI Engage curriculum.

Cephalic Presentation

A fetal presentation where the head is the presenting part and suture lines are palpable.

Breech Presentation

A fetal presentation where the buttocks are the presenting part.

Shoulder Presentation

A fetal presentation where the shoulder is the presenting part.

Compound Presentation

A fetal presentation where a fetal extremity is presenting alongside the main presenting part.

Position (Fetal)

The location of the fetal presenting part within the maternal pelvis.

Denominator

The specific fetal anatomical landmark used to describe position, such as the occiput, sacrum, or mentum.

Occiput

The denominator commonly used for cephalic presentations.

Sacrum

The denominator commonly used for breech presentations.

Mentum

The denominator commonly used for face presentations.

Direction (Fetal Position)

Indicates whether the presenting part is oriented to the maternal left or right.

Anatomical Location (Fetal Position)

Describes the orientation of the fetal denominator as anterior, posterior, or transverse within the pelvis.

Fetal Lie

The relationship of the fetal spine to the maternal spine.

Longitudinal Lie

A fetal lie where the fetal spine is parallel to the maternal spine.

Horizontal Lie

A fetal lie where the fetal spine is perpendicular to the maternal spine.

Oblique Lie

A fetal lie where the fetal spine is at an angle relative to the maternal spine.

Fetal Attitude

The relationship of the fetal head to the fetal spine.

Vertex Attitude

A fetal attitude where the head is down and the chin is tucked to the chest.

Face Attitude

A fetal attitude where the fetal neck is extended.

Maternal Structure

A maternal factor involving the anatomy of the pelvis and birth canal that affects labor progression.

Powers of Labor

Forces including uterine contractions and maternal pushing effort that drive the progression of labor.

Uterine Contractions

The involuntary primary power of labor responsible for cervical dilation and effacement.

Maternal Pushing Effort

The voluntary secondary power of labor used during the second stage to expel the fetus.

Maternal Fatigue

A factor that can influence a client's ability to cope with labor and the effectiveness of pushing.

Maternal Support

The presence of a support system which can affect maternal coping and labor progression.

Lightening

A mechanism of labor where the fetus descends into the pelvic inlet, often described as 'dropping.'

Vaginal Discharge (Pre-labor)

An increase or change in vaginal secretions that occurs as labor approaches.

Nesting

A sudden burst of energy experienced by the maternal client before the onset of labor.

Cervical Change

The process of the cervix softening, effacing, and dilating in preparation for birth.

Rupture of Membranes

The breaking of the amniotic sac, which can occur spontaneously or artificially.

Delayed Prenatal Care

A factor that can increase the risk of maternal and neonatal morbidity and mortality.

Cardiovascular Adaptation (Maternal)

Includes increases in blood volume, cardiac output, stroke volume, and heart rate during labor.

Maternal Cardiac Output

Increases during labor and resolves between contractions.

Maternal Lymphocytes

A hematologic adaptation where these white blood cell levels increase during labor.

Pulmonary Adaptation (Maternal)

Characterized by increased oxygen consumption and increased lactic acid production.

Gastrointestinal Adaptation (Maternal)

Includes delayed gastric emptying and symptoms of nausea and vomiting.

Renal Adaptation (Maternal)

Includes potential incontinence and the presence of proteinuria during labor.

Endocrine Adaptation (Labor)

Changes such as an increased estrogen to progesterone ratio and increased prostaglandins and oxytocin.

Oxytocin

A hormone that increases during labor to stimulate uterine contractions.

Reproductive Adaptation (Maternal)

Involves changes to the uterus, cervix, and pelvic floor muscles.

Fetal Position Adaptation

The fetus changes position to accommodate the maternal birth canal during labor.

Fetal Compression

Physical pressure on the fetus occurring during the labor process.

Decreased Fetal Breathing Movements

A normal fetal physiological adaptation during labor.

Transient Hypoxia (Fetal)

A temporary drop in oxygen levels that the fetus may experience during labor contractions.

Meconium

The first stool of the newborn, which may sometimes be passed in utero during labor.

Molding

The shaping of the fetal head to facilitate movement through the birth canal.

First Stage of Labor

Begins at the onset of labor and ends with full cervical dilation and effacement.

Latent Phase

A phase of the first stage of labor characterized by irregular contractions and dilation from $0$ to $4\,cm$.

Latent Phase Dilation Range

Dilation is $0$ to $4\,cm$ at onset and may increase to $6\,cm$ during the transition to active labor.

Active Phase

A phase of the first stage of labor where the presenting part descends and dilation reaches $10\,cm$.

Full Dilation

The completion of cervical opening to $10\,cm$, marking the end of the first stage of labor.

Initial Care: Client Preferences

An assessment of the client's birth plan and desired interventions at the start of labor.

True Labor Assessment

Differentiating between false labor and actual labor onset characterized by cervical change.

Uterine Contraction Monitoring

Assessment of contractions via manual palpation, tocodynamometer, or intrauterine pressure catheter.

Manual Palpation

Assessing the intensity of contractions by feeling the maternal abdomen with fingertips.

Tocodynamometer (TOCO)

An external device used to monitor the frequency and duration of uterine contractions.

Intrauterine Pressure Catheter (IUPC)

An internal device used to provide an absolute measurement of contraction intensity and resting tone.

Contraction Frequency

The time from the beginning of one contraction to the beginning of the next.

Contraction Intensity

The strength of a contraction at its peak.

Contraction Duration

The time from the beginning of a contraction to the end of that same contraction.

Resting Tone

The pressure within the uterus between contractions.

Vaginal Exam: Dilation

The measurement of the opening of the internal cervical os.

Cervical Effacement

The thinning and shortening of the cervix during labor.

Amniotic Membrane Assessment

Evaluation for color, odor, consistency, and amount of fluid after membranes Rupture.

Nitrazine Paper

Used during a vaginal exam to determine if the pH of vaginal fluid indicates ruptured membranes.

Fern Test

A diagnostic test looking for a specific pattern under a microscope to confirm the rupture of membranes.

Immunoassay Testing

A diagnostic method used to detect amniotic fluid proteins to confirm ruptured membranes.

Station

The relationship of the fetal presenting part to the level of the maternal ischial spines.

Group B Streptococcus (GBS) Screening

A diagnostic test performed at $36$ to $37\,weeks$ of gestation.

GBS Treatment

The administration of antibiotics to a client who tests positive for Group B Streptococcus.

Hepatitis B Surface Antigen (HBsAg)

A laboratory test performed to screen the maternal client for Hepatitis B.

Complete Blood Count (CBC)

A standard lab test used in labor to assess hemoglobin, hematocrit, and white blood cell count.

STI Screening

Laboratory diagnostics conducted to identify sexually transmitted infections in the maternal client.

Leopold Maneuvers

A series of four steps used to identify the fetal position and presentation.

Leopold Maneuver Timing

Should be performed before an electronic fetal monitor is placed.

Intermittent Auscultation (IA)

A fetal monitoring method used for low-risk patients, typically performed every $15$ to $30\,min$ during the first stage.

Electronic Fetal Monitoring (EFM)

Continuous monitoring used for patients not categorized as low-risk.

External Doppler

An EFM tool used to monitor the fetal heart rate through the maternal abdomen.

Internal Fetal Scalp Electrode (FSE)

An internal monitoring device attached directly to the fetal presenting part for accurate heart rate tracking.

FHR Baseline

The average fetal heart rate over a 10-minute period, excluding accelerations and decelerations.

Expected FHR Baseline

A normal fetal heart rate range between $110$ and $160\,beats\,per\,min$.

FHR Variability

Fluctuations in the baseline fetal heart rate that are irregular in amplitude and frequency.

Absent Variability

An amplitude range that is undetectable on the fetal heart rate monitor.

Minimal Variability

An amplitude range of less than $5\,beats\,per\,min$.

Moderate Variability

An amplitude range of $6$ to $25\,beats\,per\,min$, indicating normal fetal acid-base balance.

Marked Variability

An amplitude range of more than $25\,beats\,per\,min$.

FHR Accelerations

Abrupt increases in the fetal heart rate above the baseline.

FHR Decelerations

Decreases in the fetal heart rate below the baseline.

Variable Decelerations

Abrupt decreases in FHR, often shaped like a V, U, or W, caused by umbilical cord compression.

Variable Deceleration Shape

Often described as appearing like the letters V, U, or W.

Umbilical Cord Compression

The primary cause of variable decelerations in the fetal heart rate.

Early Decelerations

Gradual decreases in FHR that mirror the uterine contraction.

Fetal Head Compression

The primary cause of early decelerations during a contraction.

Early Deceleration Intervention

This pattern is benign and does not warrant medical intervention.

Late Decelerations

Gradual decreases in FHR that occur after the peak of a contraction.

Placental Insufficiency

The primary cause of late decelerations in the fetal heart rate.

Placental Abruption

A maternal condition that may be associated with the occurrence of late decelerations.

Prolonged Decelerations

A decrease in FHR of at least $15\,beats\,per\,min$ lasting between $2$ and $10\,min$.

Non-reassuring Pattern

Fetal heart rate patterns like prolonged decelerations that indicate potential fetal distress.

Maternal Hypotension

A condition associated with the development of prolonged fetal heart rate decelerations.

Rapid Cervical Dilation

A maternal factor that can cause prolonged decelerations in the fetal heart rate.