Labor and Delivery OB exam 2

Why does labor begin

mechanical and hormonal changes

Mechanical changes

uterine stretching

Hormonal changes

Increases or Decreases in certain hormones

• Term myometrium becomes more sensitive to oxytocin (causing contractions)

• Decreased progesterone metabolism in fetus may stimulate prostaglandin synthesis

• Estrogen irritates the myometrium and prometrium

Lightening

fetus settles or drops into pelvis

(may be a few weeks prior to labor or in mulatiapare prior to labor starting )

Braxton hicks

backache and contractions of the uterus occurring throughout pregnancy, intermittent and irregular and does not cause cervical change- practice contractions, don't dilate cervix

Cervical changes

occur as a result of effective uterine contractions, dilation and effacement

Dilation

opening

Effacement

thinning of cervix

Bloody show

mucous lining in cervix during labor is expelled, not a formed plug- cap of surface of cervix break due to cervical change can be caused by intercourse

Rupture of membranes

Water breaking-ROM

Ways to determine ROM

Ferning (microscope), nitrazine testing, amnisure

Spontaneous rupture of membranes (SROM)

water just breaks, need to get on fetal monitor, optimat to deliver within 24 hrs of rupture

• Might need antibiotics, labor induction with pitocin

True signs of labor 

Cervical Changes 

• Dilation

• Effacement 

5 ps of labor

passageway, passenger, powers, position, psychological response

Passage

pelvic, uterine tissues, cervical tissues, vagina, and perineum

Pelvic types

gynecoid, android, anthropoid, platypelloid