Intrapartum Complications (Video) - Vocabulary Flashcards

Vocabulary flashcards covering key concepts and terms from the intrapartum complications lecture notes.

Dysfunctional Labor

Labor that fails to progress normally, due to problems with the powers, passenger, passage, or psyche; may require augmentation or operative birth.

Ineffective Contractions

Inadequate uterine activity to propel the fetus; causes include fatigue, inactivity, electrolyte imbalance, hypoglycemia, excessive analgesia, stress hormones, pelvic/uterine factors.

Labor Dystocia

Difficult labor with slow or arrested progress; contractions may be adequate but weak; managed with fluids, position changes, pain management, anxieties reduction, and possibly amniotomy or oxytocin augmentation.

Tachysystole

Excessive uterine activity (more than five contractions in 10 minutes over 30 minutes); may include long contractions or short resting intervals; management includes reducing/stopping oxytocin and using tocolytics if indicated.

Ineffective Pushing

Weak or nonproductive pushing during second stage; caused by nonphysiologic pushing, fear, exhaustion, or analgesia; managed with position changes, encouragement, rest, and guidance for productive pushes.

Fetal Macrosomia

A very large fetus (commonly >4000 g or 8 lb 8 oz); increases risk of cephalopelvic disproportion and labor dystocia.

Cephalopelvic Disproportion

Mismatch between fetal size and maternal pelvic capacity, hindering descent and birth; may necessitate operative delivery.

Occiput Posterior (OP)

Fetal head position with occiput toward the mother's back; often causes back labor and slower rotation; may rotate to OA with certain positions.

Occiput Transverse (OT)

Fetal head in transverse lie requiring rotation to OA; labor is often longer and more uncomfortable.

Occiput Anterior (OA)

Fetal head presenting with occiput facing the front; typically the most favorable position for labor and descent.

External Cephalic Version (ECV)

Manual turning of a breech or transverse fetus to cephalic presentation to facilitate vaginal birth.

Breech Presentation

Fetal buttocks or feet present first; head is last to be born; higher cesarean rates at term; external version may be attempted; vaginal breech birth is possible in selected cases.

Multifetal Pregnancy

Twin or higher-order pregnancy; risks include uterine overdistention, malpresentation, preterm birth, and complex delivery planning.

Shoulder Dystocia

Emergency delivery of the head with shoulders stuck behind the maternal pelvis; requires rapid maneuvers (e.g., McRoberts, suprapubic pressure).

Turtle Sign

Head delivers but retracts against the perineum, signaling shoulder dystocia and the need for rapid management.

McRoberts Maneuver

Nurse/observer flexes the mother's hips toward the abdomen to straighten the pelvic curve and release impacted shoulders.

Suprapubic Pressure

Applied pressure above the pubic bone to dislodge the anterior shoulder during shoulder dystocia.

Abnormal Fetal Presentation/Rotation

Nonoptimal presentations/rotations (e.g., OP/OT, transverse) that hinder dilation and descent.

Rotation and Cardinal Movements

Normal fetal descent and rotation mechanisms through labor; maternal positions can promote rotation to OA.

Breech Delivery

Delivery of a breech fetus; often cesarean at term; external version or careful vaginal birth considered in select cases.

Pelvic Shapes

Four basic pelvic types (gynecoid, android, anthropoid, platypelloid) that influence labor mechanics and risk of CPD.

Soft Tissue Obstruction

Obstructions like bladder distention reducing pelvic space; assess and encourage voiding, possible catheterization.

Psyche in Labor

Maternal stress and anxiety affecting labor through catecholamines and altered contractions; supportive care improves outcomes.

Premature Membrane Rupture (PROM)

Rupture of membranes before onset of true labor; risk for infection and preterm birth.

Preterm PROM (PPROM)

PROM occurring before 37 weeks; high risk of infection and prematurity; management includes antibiotics and possible tocolysis and steroids.

Triple I / Chorioamnionitis

Intraamniotic infection/inflammation; signs include maternal fever, fetal tachycardia, maternal leukocytosis; requires antibiotics and testing.

Placental Alpha Microglobulin-1 (PAMG-1)

Test for amniotic fluid markers to confirm PROM when fluid leakage is present.

Fetal Fibronectin (fFN)

Protein in cervicovaginal secretions indicating preterm birth risk; results must be interpreted with other findings.

Cervical Length

Short cervix (≤25 mm) on transvaginal ultrasound associated with higher preterm birth risk; informs management with progesterone in singleton pregnancies.

Preterm Labor

Labor occurring after 20 weeks but before 37 weeks; risk factors include prior preterm birth, multiple gestation, infection, stress; management aims to delay birth and enhance fetal maturity.

Betamethasone (Celestone)

Corticosteroid given to accelerate fetal lung maturity (12 mg IM x 2, 24 hours apart) for 24–34 weeks; may be used earlier per periviable considerations.

Dexamethasone (Decadron)

Corticosteroid given as 6 mg IM every 12 hours for four doses to promote lung maturity in preterm birth.

Magnesium Sulfate

Tocolytic and fetal neuroprotection agent; monitor DTRs, urine output, respiration; antidote is calcium gluconate; therapeutic range roughly 4.8–8.4 mg/dL.

Calcium Channel Blockers (Nifedipine)

Tocolytic that reduces uterine contractions by blocking calcium; side effects include flushing, headache, hypotension; monitor BP and heart rate.

Prostaglandin Synthesis Inhibitors (Indomethacin)

NSAID tocolytic that inhibits prostaglandin synthesis; used before 32 weeks; risks include ductus arteriosus constriction and oligohydramnios; monitor fetal status.

Terbutaline

Beta-adrenergic tocolytic; not FDA-approved for long-term use in preterm labor; boxed warning; monitor for tachycardia and tachyarrhythmias.

Makena (17‑P)

17‑hydroxyprogesterone caproate; weekly IM to reduce recurrent preterm birth in prior history; not for multiple gestations.

Postterm / Prolonged Pregnancy

Pregnancy beyond 42 weeks; risks include placental aging, oligohydramnios, meconium aspiration; management includes induction and antepartum testing.

Induction of Labor

Artifically initiating labor when continuation is unsafe or undesirable; methods include pharmacologic and mechanical means.

Prolapsed Umbilical Cord

Cord descends below presenting part after rupture of membranes, risking cord compression; priority is relieving pressure and delivering promptly (often by cesarean).

Uterine Rupture

Complete or partial tear in the uterine wall; higher risk with prior uterine surgery; may require cesarean and possibly hysterectomy.

Uterine Inversion

Uterus turns inside out after delivery; presents with absent uterus in abdomen; requires rapid replacement and aggressive supportive care.

Placental Abnormalities (Accreta / Increta / Percreta)

Abnormal placental adherence to the myometrium; increases risk of severe hemorrhage; often requires planning with multiple specialists and possible hysterectomy.