Labor, Birth, & Fetal Monitoring Practice Flashcards

A complete set of vocabulary flashcards derived from the lecture notes on Labor, Birth, and Fetal Monitoring, focusing on clinical stages, medications, assessments, and fetal heart rate interpretation.

Oxytocin (Pitocin)

A medication that stimulates smooth muscle to produce contractions; used for labor induction or augmentation and postpartum to reduce the risk of postpartum hemorrhage ($PPH$).

Terbutaline (Brethine)

A beta-2 adrenergic tocolytic agent used to treat tachysystole or preterm labor, administered via $IV$ or $SQ$.

Nifedipine (Procardia)

A calcium channel blocker used as a tocolytic for preterm labor and to treat hypertension ($HTN$).

Methylergonovine (Methergine)

An ergot alkaloid used to prevent or treat $PPH$ by stimulating smooth muscle contractions; it is contraindicated for clients with $HTN$.

Carboprost Tromethamine (Hemabate)

A prostaglandin used to prevent or treat $PPH$; it should be used with caution in clients with asthma.

Powers

One of the 5 P's of labor consisting of primary powers (uterine contractions) and secondary powers (maternal pushing efforts).

Passage

One of the 5 P's of labor referring to the birth canal, including the bony pelvis, cervix, pelvic floor, vagina, and introitus.

Frequency (Contractions)

The time measured from the beginning of one contraction to the beginning of the next contraction.

Duration (Contractions)

The time measured from the beginning of a contraction to the end of the same contraction.

Intensity (Contractions)

The strength of a contraction at its peak, assessed by palpation (external) or in $mmHg$ (internal).

Resting Tone

The tone of the uterus between contractions; a relaxed uterus is essential for fetal oxygenation.

Gynecoid Pelvis

The most common and classic female pelvic type, considered the most optimal shape for vaginal labor.

Fetal Attitude

The relationship of fetal body parts to one another, typically characterized by flexion.

Fetal Lie

The relationship of the long axis (spine) of the fetus to the long axis (spine) of the mother, classified as longitudinal (vertical) or transverse (horizontal).

True Labor

The presence of regular uterine contractions that result in progressive cervical dilation and effacement.

Station

The measurement in centimeters of the fetal presenting part in relation to the maternal ischial spines (e.g., $0$ station is at the level of the spines).

Mechanism of Labor (Cardinal Movements)

The seven distinct movements the fetus makes to pass through the birth canal: engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion.

Latent Phase (First Stage)

The phase of labor where the cervix dilates from $0$ to $5 \text{ cm}$.

Active Phase (First Stage)

The phase of labor where the cervix dilates from $6$ to $10 \text{ cm}$ and contractions become regular and stronger.

Second Stage of Labor

The stage of labor extending from complete cervical dilation ($10 \text{ cm}$) to the birth of the infant.

Third Stage of Labor

The stage of labor extending from the birth of the infant to the delivery of the placenta, typically taking $5 \text{--} 30 \text{ minutes}$.

Fourth Stage of Labor

The period of maternal stabilization occurring from the delivery of the placenta until at least $1 \text{--} 2 \text{ hours}$ postpartum.

Involution

The process by which the uterus returns to its nearly prepregnant size, shape, and location after delivery.

Lochia Rubra

The initial postpartum vaginal discharge occurring on days $1 \text{--} 3$, characterized by a red color.

Lochia Serosa

Postpartum vaginal discharge occurring on days $4 \text{--} 10$, characterized by a pinkish-brown color.

Lochia Alba

Postpartum vaginal discharge occurring from day $10$ up to $8 \text{ weeks}$, characterized by a creamy white or yellow color.

BUBBLE-LER

An acronym for a focused postpartum assessment: Breast, Uterus, Bladder, Bowel, Lochia, Episiotomy/Laceration, Lower extremities, Emotional Status, and Rhogam/Rubella/Vaccines.

REEDA

A wound assessment scale used for episiotomies or surgical incisions: Redness, Edema, Ecchymosis, Discharge, and Approximation.

Apgar Scoring

A rapid assessment of newborn transition done at $1$ and $5 \text{ minutes}$ post-birth, evaluating Appearance, Pulse, Grimace, Activity, and Respiration.

Visceral Pain

Pain during labor felt from organs and nerves related to distention of the lower uterine segment, uterine contractions, and cervical dilation.

Somatic Pain

Pain during labor felt in muscles, joints, and bones related to fetal descent and stretching of the pelvis, vagina, and perineum.

Tachysystole

A condition defined as more than $5$ uterine contractions in $10 \text{ minutes}$, averaged over a $30 \text{-minute}$ window.

Moderate Variability

A fetal heart rate baseline fluctuation amplitude range of $6 \text{--} 25 \text{ bpm}$, indicating an intact central nervous system.

Accelerations

Visually abrupt increases in fetal heart rate ($15 \text{ bpm}$ above baseline for at least $15 \text{ seconds}$ if over $32 \text{ weeks}$ gestation) that are reassuring of fetal well-being.

Variable Decelerations

Abrupt decreases in fetal heart rate caused by umbilical cord compression, often requiring maternal position changes.

Early Decelerations

Gradual decreases in fetal heart rate that mirror uterine contractions, caused by fetal head compression.

Late Decelerations

Gradual decreases in fetal heart rate where the nadir occurs after the peak of the contraction, caused by uteroplacental insufficiency.

Category I FHR Tracing

Normal fetal heart rate tracings that are strongly predictive of normal fetal acid-base balance.

Intrauterine Resuscitation

Evidence-based interventions used to optimize fetal oxygenation, including changing maternal position, providing an $IV$ fluid bolus, and administering $O_2$ at $10 \text{ L/min}$. strategy.