Module 6F: Care of the Pregnant Mother During the Intra-Natal Period with Operative Obstetrics

Vocabulary practice flashcards covering labor definitions, phases, cardinal movements, operative obstetrics, and maternal pain management from Module 6F.

Labor

The series of events by which uterine contractions and abdominal pressure expel a fetus and placenta from the uterus.

Episiotomy

A surgical incision of the perineum made to prevent tearing of the perineal tissue during birth.

Duration of Contraction

The measurement in seconds from the beginning of increment to the end of decrement in a single uterine contraction.

Intensity of Contraction

The strength of uterine contractions, categorized as mild, moderate, or strong.

Frequency of Contraction

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

Increment

The phase during a contraction when the intensity is actively increasing.

Peak (Acme)

The point in a uterine contraction when it is at its strongest intensity.

Decrement

The phase during a contraction when the intensity is actively decreasing.

Augmentation of Labor

The process of assisting labor that has already started spontaneously but is not progressing effectively.

Induction of Labor

The chemical or mechanical stimulation of uterine contractions before the spontaneous onset of labor for the purpose of accomplishing delivery.

Dysfunctional Labor

A condition characterized by sluggishness of contractions, or when the force of labor is less than normal.

Eutocia

A normal process or series of events in which viable products of conception are expelled out from the uterus through the vagina.

Dystocia

Difficult or obstructed labor that can arise from problems in the mechanisms of labor.

Amniotomy

The artificial rupturing of the amniotic membranes during labor if they do not rupture spontaneously.

Trial of Labor

An attempt at labor to determine whether labor will progress normally for women following a prior cesarean section.

Operative Obstetrics

Special surgical or mechanical procedures utilized by physicians or nurses to assist the mother during labor and delivery.

Forceps Delivery

An assisted vaginal delivery using an instrument applied to the fetal head to facilitate rotation to an occiput anterior position and prevent excessive pressure.

Vacuum Extraction

A delivery method where a suction cup is placed over the fetal occiput to assist in guiding the fetal head through the birth canal.

Cesarean Delivery

The birth of the fetus accomplished through a surgical incision made directly through the mother's abdomen and uterine wall.

Analgesia

Medication that reduces the awareness and sensation of pain during labor without completely abolishing nerve sensation.

Anesthesia

The pharmacological abolition of pain sensation achieved by interrupting nerve impulse transmission.

Progesterone Deprivation Theory

The theory of labor onset stating that a shift in the ratio of estrogen to progesterone occurs, favoring an increase in estrogen.

Oxytocin Theory

The theory stating that labor is initiated as oxytocin works synergistically with prostaglandins to stimulate uterine contractions.

Placental Degeneration Theory

The theory proposing that labor contractions are triggered once the placenta reaches a predetermined biological lifespan.

Fetal Endocrine Control Theory

Also known as the Adrenal Theory; proposes that rising fetal cortisol levels reduce progesterone production while increasing prostaglandin synthesis to induce labor.

Prostaglandin Theory

Also known as the Prostaglandin Cascade; posits that the fetal membranes begin synthesizing prostaglandins, which directly stimulate labor contractions.

Lightening

The premonitory sign of labor marked by the descent and settling of the fetal head into the true pelvis, relieving diaphragmatic pressure.

Show

A premonitory sign of labor marked by the expulsion of the internal cervical mucus plug.

False Labor

Contractions that remain irregular, are felt primarily in the abdomen and groin, disappear with rest or ambulation, and do not cause cervical dilation.

True Labor

Contractions that become regular and predictable, originate in the lower back, sweep forward in waves, persist through activity, and achieve cervical dilation.

Latent Phase

The initial phase of the first stage of labor characterized by mild contractions lasting $20\text{--}40\,\text{seconds}$ and cervical dilation from $0\text{ to }3\,\text{cm}$.

Active Phase

The phase of the first stage of labor where contractions strengthen to $40\text{--}60\,\text{seconds}$ every $3\text{--}5\,\text{minutes}$, with cervical dilation progressing from $4\text{ to }7\,\text{cm}$.

Transition Phase

The final, most intense phase of the first stage of labor, with contractions every $2\text{--}3\,\text{minutes}$ lasting $60\text{--}70\,\text{seconds}$ and dilation advancing from $8\text{ to }10\,\text{cm}$.

Second Stage of Labor

The stage of labor that begins with full cervical dilation and complete effacement and terminates with the birth of the neonate.

Third Stage of Labor

The placental stage, spanning from the birth of the infant to the complete expulsion of the placenta, lasting $1\text{--}30\,\text{minutes}$.

Placental Separation

The detachment of the placenta from the uterine wall, signaled by cord lengthening, a sudden gush of blood, placenta visibility at the introitus, and uterine firming.

Placental Expulsion

The delivery of the detached placenta via natural maternal pushing or gentle fundal pressure applied only to a firmly contracted uterus.

Fourth Stage of Labor

The immediate postpartum recovery period encompassing the first $4\,\text{hours}$ after placental delivery, requiring close observation for hemorrhage.

First-Degree Perineal Laceration

A perineal laceration involving only the vaginal mucosa and perineal skin.

Second-Degree Perineal Laceration

A perineal laceration extending into the perineal muscles.

Third-Degree Perineal Laceration

A perineal laceration that tears through the perineal muscles and involves the anal sphincter.

Fourth-Degree Perineal Laceration

A severe perineal laceration extending completely through the anal sphincter and into the rectal mucosa.

Passage

The maternal pelvic canal, cervix, vagina, and perineum through which the fetus must descend during birth.

Passenger

The fetus traveling through the birth canal, particularly the fetal head whose diameter is least compressible.

Fetal Attitude

The relationship of fetal body parts to one another, reflecting the degree of flexion or extension assumed by the fetus during labor.

Fetal Lie

The relationship between the long axis (spine) of the fetal body and the long axis of the mother's body.

Fetal Presentation

The anatomical part of the fetus that enters the pelvic inlet first and contacts the cervix.

Fetal Position

The relationship of an arbitrary landmark on the presenting part of the fetus to a specific quadrant of the maternal pelvis.

Engagement

The settling of the widest transverse diameter of the fetal presenting part to the level of the maternal ischial spines (station $0$).

Station

The measurement in centimeters describing the location of the fetal presenting part relative to the level of the ischial spines.

Effacement

The progressive shortening, thinning, and drawing up of the cervical canal during labor.

Dilatation

The enlargement, stretching, or widening of the external cervical os from $0\,\text{cm}$ to $10\,\text{cm}$.

Descent

The progressive downward progression of the fetal biparietal diameter through the pelvic inlet and birth canal.

Flexion (Cardinal Movement)

The forward bending of the fetal head onto the chest, ensuring the smallest anteroposterior diameter presents to the birth canal.

Internal Rotation

The turning of the fetal head within the pelvis so that the occiput aligns with the maternal pelvic outlet.

Extension (Cardinal Movement)

The cardinal movement occurring when the fetal head passes beneath the symphysis pubis, allowing the face and chin to be born.

External Rotation (Restitution)

The realignment of the fetal head with the fetal shoulders, facilitating the delivery of the anterior shoulder first.

Expulsion (Cardinal Movement)

The final cardinal movement of labor during which the remainder of the infant's body smoothly slips out of the mother.

Kleihauer-Betke Test

A laboratory test performed on maternal blood to detect fetomaternal hemorrhage, where fetal red cells appear bright pink and maternal cells appear pale/ghost-like.

Midline Episiotomy

An episiotomy incision made straight down from the posterior fourchette toward the anus, offering minimal blood loss and easier healing but a higher risk of rectal tearing.

Mediolateral Episiotomy

An episiotomy incision angled at 45^\n\circ\text{--}60^\circ away from the midline, decreasing rectal tearing risk but causing more blood loss and discomfort.

Dick-Read Method

A childbirth preparation approach focused on breaking the fear-tension-pain cycle using physical conditioning, conscious relaxation, and controlled breathing.

Lamaze Method

A psychoprophylactic childbirth technique that utilizes conditioned responses, mental focusing, relaxation, and patterned breathing to manage pain during contractions.

Bradley Method

A childbirth preparation approach designated as husband-coached childbirth, emphasizing deep abdominal relaxation, slow breathing, and partner support.

Pudendal Nerve Block

A regional nerve block administered transvaginally at the level of the ischial spines to provide perineal anesthesia lasting approximately $60\,\text{minutes}$.

Classical Cesarean Incision

A vertical surgical incision into the uterine corpus providing extensive operative exposure, but carrying a heightened risk of subsequent uterine rupture.

Low Segment Cesarean Incision

A transverse surgical incision placed in the lower uterine segment, associated with reduced blood loss, easier wound closure, and a lower rupture risk in future pregnancies.