5B Fourth Stage of Labour Vocabulary

Flashcards on the Fourth Stage of Labour and Newborn Care

Involution

The return of the uterus to its pre-pregnancy state after birth.

F+C

Ensuring the uterus feels 'firm and central' after birth by palpation, an important step to minimise bleeding.

Fundal Rub/Massage

Applying downward pressure onto the fundus to induce uterine contraction.

Uterotonic drug

A drug that may be required to promote uterine contraction if there is an excess of bleeding (PPH).

Postnatal Maternal Assessments

Maternal assessments to be performed after birth include Vital signs Temperature (36.0-37.5oC) Pulse (60-100 bpm) Respiratory Rate (12-20 breaths per minute) Blood Pressure (100/60 - <140/90 mmHg) Perineum Palpate the uterus Observe vaginal loss (Lochia) Bladder care.

Lochia

Vaginal loss after birth, which should be observed for volume, color, and clots.

Fetal Transition Components

Increased systemic vascular resistance with separation from placental vasculature, closure of right-to-left shunts, lowering of pulmonary vascular resistance, clearance of fluid from airways, increased metabolic rate, and increased catecholamine levels.

Apgar score

Quantitative assessment tool to assess the well being of a newborn; clinical indicator of the newborn's condition shortly after birth. Stands for appearance, pulse, grimace, activity, and respiration

Transition Assessment

Newborn assessment based upon the newborns’ response to stimulation, breathing, and muscle tone; can be transferred to resuscitare for further assessment

Newborn Stimulation

Being born into a cooler environment and being dried.

Delayed Cord Clamping

Allows for improved blood transfer from placenta to the newborn, which can enhance iron stores and reduce the risk of anaemia.

Newborn Assessment Following instrumental or vacuum birth

Assessment of the newborn includes: Inspection and palpation of the scalp and nape of the neck Head circumference measurements - urgent escalation is appropriate

Thermoregulation

Refers to the process by which the body maintains its internal temperature within a narrow range to optimise metabolic functions.

Conduction

Loss of heat from the body surface to cooler surfaces in direct contact

Convection

Flow of heat from body surface to cooler air- the naked newborn is exposed to cooler surrounding air. Example: drafts

Evaporation

Loss of heat that occurs when a liquid is converted to a vapour amniotic fluid evaporates from the newborn's body taking heat with it

Radiation

Loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity

The Golden Hour

Time immediately following birth until at least the first hour following birth and/or completed the first breastfeed. Otherwise known as the Fourth stage of labour.

Skin to Skin Contact Phase

During this time, the woman’s naked chest and body is in direct contact with the newborn’s naked body. supports Step 4 of the Ten Steps to Successful Breastfeeding

Exclusive Breastfeeding

The newborn receives only breast milk and any prescribed medicines (oral rehydration solution, vitamins and minerals) but NO formula or non-human milk such as water or other fluids/foods

Vitamin K for Newborns

Theory behind supplementing newborns with Vitamin K is to prevent haemorrhagic disease of the newborn (HDN).

Haemorrhagic Disease of the Newborn

Rare bleeding disorder that occurs usually due to trauma and is thought to be related to a lack of accessible Vitamin K

Moulding

Change in shape of head due to the over- riding of the cranial bones at the sutures in response to passage through birth canal

Caput succedaneum

Refers to the edema that occurs on a newborns head as a result of pressure during birth, specifically between the skin and the periosteum of the skull

Cephalohematoma

Not considered a normal variation but is worth noting because it can happen relatively frequently. Collection of blood under perisoteum due to trauma. Swelling does not cross the suture line. Swelling appears about 12 hours after birth. There is no treatment the as blood will be reabsorbed.

Milia

Distended sebaceous glands often seen over the nose.

Erythema toxicum

White papules on erythematous base. Red blotchy patches and small bumps on skin. Occurs in 50% of newborns and no treatment is required.

Acrocyanosis

Peripheral cyanosis of the hands and feet. Blueish colour. Common in the first 24 hours after birth due to immature circulation

Mongolian Spots

Patch of blue-black colour distributed over sacral regions of infants of Afrian or Asian descent. Often spontaneously disappears by childhood.

Initial Newborn Assessment

An initial assessment of the newborn is often made without any direct contact or intervention for at least the first hour whilst the newborn lies skin to skin with its mother and may initiate the first breastfeed.