CM - 3 - Labor & Delivery PF

normal birth

the goal of ________ is to achieve a healthy mother and child with the least possible level of intervention that is compatible with safety

valid reason

in normal birth, there should be a _________ to interfere with the natural process

• spontaneous in onset

• 37-42 weeks of gestation

• low risk at start of labor through delivery

• vertex presentation of the infant

• spontaneous vaginal delivery with mother and infant in good condition

NORMAL BIRTH criteria are: (5)

low

a normal birth is ____ risk at the start of labor through the delivery

37-42

a normal birth happens at ___-____ weeks of gestation

spontaneous

a normal birth is ___________ in onset

vertex

a normal birth is _______ presentation of the infant

vertex

______ presentation means a fetus is in a headfirst, head down position with its chin tucked towards its chest, facing the patient’s spine

• preterm labor

• severe preeclampsia

• higher-order multiples

• pre-preg chronic illness

• age >35

basic categories of high risk pregnancies are: (5)

18

bed rest is prescribed to ___% of pregnant women in the US per year, but 1/3 of what is prescribed is reported noncompliant

• strict trendelenburg

• strict no upright

• with bathroom privileges

• limitation of activity

the 4 categories of bed rest are:

• uterine contractions

• menstrual like cramps

• abdominal or intestinal cramps with or without diarrhea

• pelvic pain or pressure

• suprapubic pressure

• increased vaginal discharge

• backache unresponsive to postural changes

• ruptured membranes

• bloody show

signs of preterm labor: (read)

chronic

_______ HTN would have been present before pregnancy or diagnosed before week 20

gestational

_________ HTN is high BP for the first time mid-pregnancy

>140/90

chronic HTN is a value of _____/____

DOES NOT

chronic HTN first diagnosed during pregnancy (does/does not) resolve postpartum

TRUE

T/F: gestational HTN may show signs of preeclampsia

preeclampsia

_________ is persistent high blood pressure that develops during pregnancy or the postpartum period

grand mal seizures

neurologically, eclampsia can cause the onset of ____________

• severe HA

• swelling in hands, face, ankles, legs

• flashing lights in visual field

• R sided pain under rib cage

• severe heartburn

symptoms of preeclampsia: (5)

• teenagers

• mothers >35 yo

• first time pregnancy

• african american

• obesity

• multiple gestation

• hx of chronic HTN

risk factors for preeclampsia are: (read)

gestational diabetes mellitus

____________ is glucose intolerance or insulin resistance that begins during pregnancies

hospital, birth center, home birth

three options for birth settings are _______, ________, and ________

satisfaction rate

birth centers have a very high ______________

cascade

there is a “_______” of interventions available for medical labor induction

TRUE

T/F: the sweeping or stripping of membranes is minimally invasive

pitocin

______ is synthetically produced oxytocin that causes contractions

uterine rupture

a key risk of the use of pitocin is the risk for __________

24 hrs

once the water breaks, baby should be delivered within ___ hours

prostaglandin

sweeping or stripping the membranes increases the local ___________ production to soften the cervix

where you live in the US

PT intervention during L&D depends a lot on __________________

bed rest

________ can be long term or intermittent

eccentrically lengthening

prenatal OP pelvic floor goals include _______________ pelvic floor muscles

lightening

________ is the term for the point when the baby/belly drops and settles lower in your pelvis

2 hours

the cervical dilation rate is about 1 cm every _______

3

labor has ____ stages

labor, delivery, afterbirth

the three stages of birth are _____, ______, and _______

contractions, PT intervention

the first stage of labor is __________ and is when facilitation of the fetus engaging into the pelvis occurs, which __________ can help with

• open knee-chest position

• standing leaning forward on counter

• semi-sitting leaning backward with abdominal lifting

possible positions for stage 1 of labor are: (3)

partner

there are labor techniques that can be ______ assisted

pushing and birth, medical intervention

stage 2 of labor is the ___________ that requires __________

10

stage 2 of labor is when the cervix is _____ cm dilated

primigravida

__________ is a term indicating it is a first pregnancy

multigravida

__________ is a term indicating it is a second or subsequent pregnancy

longer

pushing labor for a first pregnancy is (shorter/longer) than subsequent pregnancies

epidurals

________ delay pushing for up to 2 hours until the head is in OA or visible in outlet

4-5

epidurals are administered at ___-___ cm dilated

spontaneous

if not using an epidural, wait for __________ pushing and use oxytocin if needed

position changes

____________ can help enhance pushing labor if not using an epidural

1-2 hours

normal pushing labor (not contraction labor) lasts ___-___ hours

episiotomy

forceps delivery requires _________; this has been on the decline in terms of use

vacuum extraction

now, __________ is more commonly used than forcep delivery is instrumentation is needed

2 inches

episiotomies used to be quite common but have declined in use, if they are done they are ______ long and done with scissors and local anesthetic

3 and 4

grade/s ______ of perineal tears should always be seen by a PT

1, abrasion

a grade ___ perineal tear is skin and superficial fatty structures and is sometimes called an _________

baby is in the wrong position for vaginal birth

c-sections are most commonly done because _____________________

37-38

planned c-sections are scheduled at ___-___ weeks GA to avoid emergency c-section

dystocia

________ is the inability of the fetus to descend through the pelvis in a timely manner

• labor

  • squatting, standing, walking, heel sitting while leaning forward, leaning, ball sitting, kneeling, quadruped

• delivery

  • squatting, sitting, sidelying, kneeling, quadruped

PT advised birthing positions: (read)

semi-reclined, lithotomy

OB preferred birthing positions are _______ and ________

baby crowns

OB preferred birthing positions are usually not involved until ___________

BEFORE BIRTH

if a mother has an msk dysfunction, work on these positions in the clinic ___________

standing

labor position to avoid with spinal stenosis is ___________

ANYTHING forward flexion

labor positions to avoid with herniated nucleus pulposus are _______________

asymmetrical postures

labor positions to avoid with SIJ dysfunction are ______________

sidelying, squatting, lithotomy

labor positions to avoid with pubic symphysis dysfunction are ________, _________, and _________

coccydynia

____________ is tailbone pain that is common in pregnancy

anything with tailbone pressure - semi-reclined, sitting, lithotomy

labor positions to avoid with coccydynia are ____________________

breathing, thrombophlebitis, bowel movements

acute post-partum care should focus on _________, _________, and __________ among many other things

6-8

OP postpartum screenings for PT are usually done ___-___ weeks after delivery