Ob/Peds- Exam 1- Labor and Delivery

What is an OB/GYN

MD or DO that has completed a residency in obstetrics and gynecology

Trained in medical problems

Trained in C sections

Manage high risk pregnancies

What is a Midwife

Basically can do everything an OB/GYN can do expect the C-section surgery

Focus on wellness

What's a doula

Provides emotional support and advice for mom and family and suggestions for easing discomfort

A surgical procedure to deliver a baby through incisions in the abdomen and uterus

Cesarean section

A vaginal delivery in a woman who has previously had a cesarean section

VBAC

-vaginal birth after cesarean

Eligibility indications for a VBAC

Suitable for women with a low transverse uterine scar

Indications for desire for vaginal birth for VBAC

Preference to avoid surgery and its associated risks

Risk for VBAC

Uterine rupture

Emergency cesarean

Benefits for VBAC

For mother= shorter recovery time, lower risk of infection, and less blood loss compared to repeat cesarean

For future pregnancies= fewer complications in subsequent pregnancies and deliveries

Pre labor contractions are called?

Braxton Hicks Contractions

Differences of Braxton Hicks Contractions from tru elabor

True labor= contractions are regular, progressively stronger and closer together

Braxton hicks= do not increase in intensity and may stop with change in activity or position

Stage 1

Early labor

Duration of stage 1 early labor

Hours to days

Cervical dilation of stage 1 early labor

0-6cm

Contractions of stage 1 early labor

Mild to moderate, irregular becoming more regular over time

Symptoms of stage 1 early labor

Lower back pain, cramping, bloody show (Mucus plug release)

Duration of stage 1 active labor

4-8 hrs

Cervical dilation of stage 1 active labor

6-8 cm

Contractions of stage 1 active labor

Stronger, more regular, and closer together

Symptoms of stage 1 active labor

Intense contractions, possible nausea, WATER BREAKING

When does water breaking occur

Stage 1 Active Labor

Duration of stage 1 transition

30 minutes to 2 hrs

Cervical dilation of stage 1 transition

8-10 cm

Contractions of stage 1 transition

Very strong, 2-3 minutes apart, lasting 60-90 seconds

Symptoms of stage 1 transition

Intense pressure, shaking and irritability

What helps with the dilation of the cervix

Effacement

What is effacement

Thinning of the cervix

What stage does delivery of the baby occur

Stage 2

Duration of stage 2 delivery of the baby

Minutes to few hours

Cervical dilation of stage 2 delivery of the baby

Fully dilated at 10 cm

When does pushing, crowning and delivery occur?

Stage 2, delivery of the baby

What is it when the baby`s head becomes visible

Crowning

When does delivery of the placenta occur

Stage 3

Duration of stage 3 delivery of the placenta

5-30 minutes after baby is born

Duration of stage 4 recovery

First 1-2 hrs after delivery

What is normal head down position

Vertex presentation

What position is the most common and has the best outcome

Occiput anterior (Face down to the table)

What are the 2 types vertex position

Occiput anterior

Occiput posterior (sunny side up birth) (face up_

What is it when the baby is lying sideways across the abdomen

Transverse lie

What position will always need a C sections

Transverse lie

What are the 3 different breech presentations

Complete

Franks

Incomplete

Complete breech

Butt first with both legs down

Frank breech

Butt first with legs up

Incomplete breech

Butt first with one leg down and one leg up

After what period of time will the baby normally settle into the position they will likely be in for the birthing process

After 36 weeks

Breech presentation has increased risk of

Intracranial hemorrhage

Dislocation/injury to the neck, hip or shoulder

Prolapsed umbilical cord

Genital injury

Premature placental rupture/apnea for baby

Death

Absolute contraindications to cephalic version

Previous scar on the uterus

Placenta praevia

Unexplained APH

Pre-eclampsia

Multiple pregnancy

Relative contraindications to cephalic versions

Rhesus isoimmunisation

Elderly primigravida

IUGR

Oligo/ployhydramnios

Complications of cephalic versions

Umbilical cord entanglement

Abrupt on of placenta

Preterm labor

Premature rupture of membrane

Severe maternal discomfort

What surgical intervention is a surgical cut to the perineum?

Episiotomy

What is an epiostomy used for

Present internal tissue damage

Risk for episiotomy

Big increase in chance of infections cause of all material coming out of mom into the cut they make

Side effects of vacuum to baby

Head swelling

Shoulder dystocia

-anterior fetal shoulder becomes stuck on maternal pubic symposium delaying the birth of the baby`s body

Side effects of baby to forceps

Bruising

Shoulder dystocia (brachial plexus injuries)

Trauma from forceps

Cord clamping has health benefits for baby how?

Health benefits for baby between 30-60 seconds

What is a big red flag for postpartum infection

Any fever for a postpartum mom is an immediate red flag

APGAR scoring chart total comprehension

7-10= Excellent condition

4-6=moderately depressed

0-3=-3 Severely Depressed