Reproduction: Intrapartum - Labor and Birth Study Guide Flashcards

A set of 100 flashcards based on the Intrapartum Labor and Birth Study Guide covering vocabulary, assessment techniques, stages of labor, and obstetric emergencies.

How is Abruptio placenta defined?

Premature separation of a normally implanted placenta from the uterine wall after $20$ weeks gestation but before birth, classically causing painful dark bleeding, uterine tenderness, and fetal distress.

What is fetal Attitude?

The relationship of fetal body parts to one another, most often referring to flexion or extension of the fetal head.

What is the normal range for baseline fetal heart rate?

The average rate over a $10$-minute period is $110-160\,bpm$.

What is a Cesarean section?

Surgical birth of the fetus through incisions in the mother’s abdomen and uterus.

What occurs during Crowning?

The fetal head remains visible at the vaginal opening and no longer retracts between contractions.

How is Dilation measured during labor?

The opening and enlargement of the cervix, measured from $0\,cm$ to $10\,cm$.

What is the role of a Doula?

A trained support person providing emotional, physical, and informational support without performing clinical tasks.

How is the Duration of a contraction measured?

From the beginning of a contraction to the end of that same contraction.

What is Dystocia?

Difficult or abnormal labor related to powers, passenger, passageway, position, or psychological response.

What is the typical cause of an early deceleration?

Fetal head compression; these are generally benign and mirror the contraction.

What is Eclampsia?

Seizures in a client with preeclampsia that cannot be explained by another cause; it is an obstetric emergency.

What is Effacement?

Thinning and shortening of the cervix during labor, measured from $0\%$ to $100\%$.

When is Engagement said to have occurred?

When the presenting fetal part (usually the head) reaches the level of the maternal ischial spines ($0$ station).

What is an Episiotomy?

A surgical incision made in the perineum to enlarge the vaginal opening during birth.

How is the Frequency of contractions measured?

From the beginning of one contraction to the beginning of the next contraction.

What is the induction of labor?

The artificial stimulation of uterine contractions before spontaneous labor begins.

How is the Intensity of a contraction described or measured?

Described as mild, moderate, or strong by palpation, or measured in $mm\,Hg$ with an intrauterine pressure catheter.

What does a late deceleration indicate?

Uteroplacental insufficiency; it begins after the contraction starts and returns to baseline after the contraction ends.

What is fetal Lie?

The relationship of the long axis (spine) of the fetus to the long axis (spine) of the mother.

What is Lightening?

The descent of the fetal presenting part into the true pelvis.

How is Molding defined?

The shaping of the fetal head as cranial bones overlap during vaginal birth.

What is the classic sign of Placenta previa?

Painless bright red bleeding after $20$ weeks gestation.

How is fetal Position documented?

With abbreviations representing the relationship of the presenting part to the mother's pelvis, such as LOA, ROA, LOP, or ROP.

What criteria define Preeclampsia?

Hypertension after $20$ weeks with organ involvement such as proteinuria or visual changes.

What is precipitate labor and birth?

A very rapid labor and birth, usually within $3\,hours$ of the onset of contractions.

When is labor considered Premature labor?

When regular uterine contractions cause cervical change before $37$ weeks gestation.

What is fetal Presentation?

The fetal part that enters the pelvis first, such as cephalic, breech, or shoulder.

What happens during a Prolapsed cord?

The umbilical cord slips below or beside the presenting part after the membranes rupture, risking cord compression.

What is Station?

The measurement of fetal descent in relation to the maternal ischial spines.

What are Tocolytic agents?

Medications like nifedipine and magnesium sulfate used to slow or stop uterine contractions in preterm labor.

What is the shape and cause of a Variable deceleration?

An abrupt decrease often V, U, or W shaped, usually caused by umbilical cord compression.

Which hormone levels increase near the end of pregnancy to initiate labor?

Estrogen.

Which hormone levels decrease near the end of pregnancy?

Progesterone.

What is the purpose of myometrial gap junctions?

They help uterine muscle cells coordinate contractions.

What happens to oxytocin receptors near the end of pregnancy?

They increase, which increases uterine sensitivity to oxytocin.

How does fetal cortisol contribute to labor?

It helps increase prostaglandin production.

What are the two major roles of prostaglandins during labor?

They help soften and ripen the cervix and stimulate uterine contractions.

What are the two main functions of uterine contractions?

To dilate the cervix and push the fetus through the birth canal.

When do primiparas typically experience lightening?

$2\,weeks$ or more before labor begins.

What is "Nesting"?

An increased energy level where the client prepares the nursery, usually occurring $24-48\,hours$ before labor.

What causes the pink-tinged secretions known as Bloody Show?

Small cervical capillaries rupture as the cervix softens and the mucus plug is expelled.

What are Braxton Hicks contractions?

Irregular practice contractions that do not cause progressive cervical dilation.

When should a provider be called regarding Braxton Hicks contractions?

If they last longer than $30\,seconds$, occur more than $4-6$ times per hour, or occur before term.

What is PROM?

Prelabor rupture of membranes occurring before labor begins.

What are the two main risks after the membranes rupture?

Ascending infection and cord prolapse.

What is the major difference between True and False labor?

True labor causes progressive cervical dilation and effacement, while false labor does not.

What is the contraction timing in True labor?

Regular and becoming closer together, often $4-6\,minutes$ apart.

Where does discomfort usually start in True labor?

In the back, radiating to the front of the abdomen.

How do True labor contractions respond to activity changes?

They continue despite walking, fluids, or change in position.

What are the traditional 5 Ps of labor?

Passageway, Passenger, Powers, Position, and Psychological response.

Name three 'Additional Ps' mentioned in the study guide.

Philosophy, Partners, Patience, Patient preparation, or Pain management.

What is the difference between the False pelvis and the True pelvis?

The false pelvis is the upper flared portion; the true pelvis is the lower bony passageway the fetus must travel through.

Why is chest compression beneficial during fetal passage through the mid-pelvis?

It helps remove fetal lung fluid and mucus.

Which pelvic shape is most favorable for vaginal birth?

Gynecoid pelvis.

What is an Anthropoid pelvis?

A pelvis with an oval inlet and deeper cavity, more favorable than android or platypelloid.

What are the characteristics of an Android pelvis?

Funnel-shaped or heart-shaped inlet with slower fetal descent and a poorer labor prognosis.

How is a Platypelloid pelvis described?

A flat pelvis with a shallow cavity, making descent through the mid-pelvis difficult.

What is Caput succedaneum?

Edema of the scalp at the presenting part that crosses suture lines and resolves in days.

What is a Cephalohematoma?

A collection of blood under the periosteum that does not cross suture lines.

What is the most favorable fetal Attitude for vaginal birth?

Full flexion with the chin tucked.

What is a Longitudinal lie?

When the fetal spine is parallel to the maternal spine.

What is a Transverse lie?

When the fetal spine is perpendicular to the maternal spine.

Which cephalic presentation is most favorable?

Vertex, where the head is fully flexed.

What is a Frank breech?

The buttocks present first with the legs extended up toward the face.

What is a Footling breech?

One or both feet present first, increasing the risk of cord prolapse.

What is shoulder dystocia?

An emergency where the fetal shoulders do not deliver after the head emerges.

What is the 'turtle sign'?

When the fetal head emerges slowly and then retracts toward the vagina, a sign of shoulder dystocia.

Which fetal position is the most common and favorable?

LOA (Left Occiput Anterior).

What is represented by a station of 0?

The presenting part is at the level of the maternal ischial spines.

What does a positive station (e.g., +4) indicate?

The fetus is below the ischial spines and near birth.

What are Leopold maneuvers used for?

Abdominal palpation techniques to determine fetal presentation, position, lie, and engagement.

What does Maneuver 1 of Leopold maneuvers identify?

What fetal part is in the fundus (head or buttocks).

What is the purpose of Leopold Maneuver 2?

To determine which side the fetal back is on.

Where are Fetal Heart Tones (FHTs) usually best heard?

Through the fetal back.

What does Maneuver 3 of Leopold maneuvers determine?

The presenting part and whether the head is ballotable (not engaged).

What information does Maneuver 4 of Leopold maneuvers provide?

Whether the fetal head is flexed and engaged.

What are the three phases of a uterine contraction?

Increment (building up), Acme (peak), and Decrement (letting down).

What is the importance of the resting interval between contractions?

It allows uteroplacental blood flow to recover.

What is the normal resting tone in active labor?

$12-18\,mm\,Hg$.

What contraction intensity is usually required to initiate cervical dilation?

About $30\,mm\,Hg$ or greater.

What does cloudy or foul-smelling amniotic fluid suggest?

Infection.

What are the implications of green amniotic fluid?

It suggests meconium staining, which can be associated with fetal hypoxia or meconium aspiration.

How does Nitrazine paper indicate amniotic fluid presence?

It turns blue/green to deep blue because amniotic fluid is alkaline.

What are the four stages of labor?

Dilation, Expulsive, Placental, and Restorative.

What defines the First Stage of labor?

From the onset of true contractions to complete dilation at $10\,cm$.

What are the dilation ranges for the Latent vs. Active phases?

Latent phase is $0-6\,cm$; Active phase is $6-10\,cm$.

What defines the Second Stage of labor?

From complete dilation at $10\,cm$ to the birth of the newborn.

What defines the Third Stage of labor?

From the birth of the newborn to the separation and delivery of the placenta.

What is the Schultz mechanism of placental delivery?

The fetal side (shiny gray side) presents first; known as 'shiny Schultz.'

What is the Duncan mechanism?

The maternal side (red raw side) presents first; known as 'dirty Duncan.'

What is the normal blood loss for a vaginal birth?

About $500\,mL$.

What defines the Fourth Stage of labor?

From the delivery of the placenta to maternal physiologic stabilization, usually the first $1-4\,hours$.

What is the priority assessment for a boggy fundus?

Massage the fundus until firm and assess for bladder distention.

What are the four cardinal signs of Amniotic Fluid Embolism?

Respiratory failure, altered mental status, hypotension, and DIC.

What is the major sign of Placental abruption?

Sudden onset of painful dark red vaginal bleeding and a rigid uterus.

What is DIC?

A clotting disorder where widespread clotting uses up platelets and factors, leading to hemorrhage.

What defines Placenta accreta?

Abnormal attachment where the placenta attaches too deeply into the uterine wall but does not invade muscle.

What is the immediate nursing action for a prolapsed cord?

Call for help and use a sterile-gloved hand to lift the presenting part off the cord while positioning the mother in knee-chest or Trendelenburg.

What is the most reliable early sign of Uterine rupture?

Sudden fetal distress or bradycardia.

What characterizes Hyperemesis gravidarum?

Severe nausea and vomiting causing $>5\%$ weight loss, dehydration, ketonuria, and electrolyte imbalance.