Nursing Management of Labor and Birth at Risk

Vocabulary flashcards covering key terms and definitions related to dystocia, preterm and postterm labor, obstetric emergencies, and birth interventions.

Dystocia

Abnormally slow or protracted labor diagnosed during the first or second stage; leading cause of cesarean births.

Shoulder dystocia

Impaction of the fetal shoulders after the head is delivered, preventing birth and requiring special maneuvers.

McRoberts maneuver

Maternal thighs are sharply flexed and abducted to straighten the pelvic curve and relieve shoulder dystocia.

Suprapubic pressure

Light pressure applied just above the pubic bone to push the fetal anterior shoulder downward and free it from behind the symphysis during shoulder dystocia.

Hypertonic uterine dysfunction

Uncoordinated, painful, high-tone contractions that impede cervical dilation and fetal descent.

Hypotonic uterine dysfunction

Weak, infrequent contractions that are insufficient to dilate the cervix or move the fetus downward.

Protracted disorders

Slower-than-normal progress of cervical dilation or fetal descent during labor.

Arrest disorders

Complete cessation of cervical change or fetal descent after prior normal progress.

Precipitate labor

Entire labor and birth occur in fewer than 3 hours, increasing risk of trauma.

Pelvic contraction

Reduced pelvic diameters that obstruct passage of the fetus and contribute to dystocia.

Occiput posterior position

Fetal head faces maternal sacrum; common malposition prolonging labor and causing back pain.

Breech presentation

Fetal buttocks or feet present first, raising risk for dystocia and operative birth.

Macrosomia

Estimated fetal weight greater than 4,000 g (8.8 lb); associated with shoulder dystocia and cesarean delivery.

Cephalopelvic disproportion (CPD)

Fetal head is too large or maternal pelvis too small for vaginal birth.

Psychological distress

Fear, anxiety, helplessness, loneliness, or fatigue that can inhibit labor progress and cause dystocia.

Preterm labor

Regular uterine contractions with cervical change occurring between 20 and 37 weeks’ gestation.

Tocolytic drugs

Medications such as magnesium sulfate, indomethacin, and nifedipine used to delay preterm birth for 2–7 days.

Betamethasone

Antenatal corticosteroid given to accelerate fetal lung maturity when preterm birth is expected.

Fetal fibronectin test

Cervicovaginal assay used to help predict risk of spontaneous preterm labor.

Postterm pregnancy

Gestation that extends beyond 42 weeks.

Postmaturity syndrome

Fetal condition in postterm pregnancies marked by meconium staining, loss of fat, and placental insufficiency.

Intrauterine fetal demise

Death of the fetus in utero after 20 weeks; confirmed by absent cardiac activity on ultrasound.

Umbilical cord prolapse

Umbilical cord slips below or beside the presenting part, causing compression and rapid fetal deterioration.

Placental abruption

Premature separation of a normally implanted placenta from the uterine wall, leading to bleeding and hypoxia.

Uterine rupture

Tear in the uterine wall, often signaled by sudden fetal bradycardia and maternal pain; requires emergency cesarean birth.

Amniotic fluid embolism

Entry of amniotic fluid into maternal circulation causing sudden hypotension, hypoxia, and coagulopathy (DIC).

Labor induction

Medical or surgical stimulation of uterine contractions before their spontaneous onset to achieve birth.

Labor augmentation

Enhancement of ineffective spontaneous contractions after labor has begun.

Bishop score

Five-component cervical scoring system used to predict the success of labor induction.

Cervical ripening

Softening and thinning of the cervix by mechanical, surgical, or pharmacologic methods before induction.

Oxytocin

IV synthetic hormone used to induce or augment labor after the cervix is deemed ripe.

Amnioinfusion

Intrauterine instillation of warmed sterile fluid to relieve cord compression or dilute thick meconium.

Forceps-assisted birth

Use of curved metal instruments applied to the fetal head to provide traction during the second stage.

Vacuum-assisted birth

Application of suction cup to the fetal scalp to aid descent and birth; leaves transient scalp marks.

Cesarean birth

Surgical delivery of the fetus through abdominal and uterine incisions (classic or low transverse).

Vaginal birth after cesarean (VBAC)

Attempted vaginal delivery following a previous cesarean birth; requires strict criteria and readiness for emergency surgery.

Trial of labor after cesarean (TOLAC)

Carefully monitored attempt at labor that may result in a VBAC if successful.

Shoulder presentation

Transverse lie in which the fetal shoulder is positioned over the cervix; usually necessitates cesarean delivery.

Hydramnios (polyhydramnios)

Excess amniotic fluid volume; risk factor for cord prolapse and dysfunctional labor.

Chorioamnionitis

Infection of the amniotic membranes and fluid; associated with maternal fever and ineffective labor.

Magnesium sulfate

Tocolytic and anticonvulsant agent used to delay preterm labor and prevent eclamptic seizures.

Indomethacin

NSAID tocolytic that inhibits prostaglandin synthesis to reduce uterine contractions; usually limited to <32 weeks.

Nifedipine

Calcium-channel blocker used orally to relax uterine muscle and delay preterm labor.

Group B streptococcus prophylaxis

Intrapartum antibiotics given to colonized or high-risk birthing parents to prevent neonatal GBS infection.