Labor & Birth Review Flashcards

A set of 60 vocabulary flashcards covering the stages, physiological factors, procedures, medications, and fetal monitoring aspects of labor and birth.

Lightening

The descent of the fetus into the pelvis, occurring as a sign of impending labor.

Cervical Ripening

Changes in the cervix, including softening or 'ripening,' that signal the approach of labor.

Bloody Show

The rupture of tiny blood vessels in the cervix as it thins and dilates, producing blood mixed with fluid and mucus.

Nesting

A potential sign of impending labor characterized by a sudden burst of energy to prepare for the baby.

GI Distress

Symptoms such as nausea, vomiting, or diarrhea that may occur as labor approaches.

Labor

Forceful and painful uterine contractions that effect cervical dilation and cause the fetus to descend through the birth canal.

True Labor

Characterized by cervical change, rupture of membranes, fetal descent, and contractions that become stronger, more regular, and longer despite comfort measures.

False Labor

Characterized by Braxton-Hicks contractions with no pattern that may disappear with rest or activity and do not cause cervical change.

First Stage of Labor

The stage of cervical effacement and dilation, consisting of three phases: Latent (early), Active, and Transition.

Second Stage of Labor

The stage of fetal expulsion, lasting from $10\,cm$ or complete dilation until the full delivery of the infant.

Third Stage of Labor

The stage of placental separation and expulsion, starting from the delivery of the infant to the delivery of the placenta.

Fourth Stage of Labor

The first $1-2\,hours$ postpartum, which is a clinically significant period due to maternal and fetal risks.

Dilation

The widening of the external os, expressed in centimeters from a few millimeters to $10\,cm$.

Effacement

The result of muscle fibers at the internal os stretching the endocervix upward, expressed as a percentage from $0\%$ to $$100\%\text{ (completely thinned out)}.

Station

The location of the lowermost part of the fetal presenting part in relation to the ischial spines.

Zero (0) Station

The point where the biparietal diameter of the fetal head is at the level of the ischial spines.

Ischial Spines

The anatomical landmark used to determine station; above the spines is documented as negative ($-3, -2, -1$) and below as positive ($+1, +2, +3$).

Powers

One of the 4Ps of labor, referring to uterine contractions and their ability to effect dilation, effacement, and descent.

Passage

One of the 4Ps of labor, referring to the bony pelvis and soft tissues (cervix, vagina, pelvic floor) the fetus must navigate.

Passenger

One of the 4Ps of labor, referring to the fetus (size, presentation, lie, attitude) and the placenta.

Person / Psyche

One of the 4Ps of labor, referring to the laboring person's coping skills, support system, fatigue, and emotional response.

Increment

The period of increasing strength in the uterine contraction cycle.

Peak (Acme)

The point of greatest intensity during a uterine contraction.

Decrement

The period of decreasing strength following the peak of a uterine contraction.

Contraction Frequency

The time measured from the beginning of one contraction to the beginning of the next contraction, expressed in minutes.

Contraction Duration

The time measured from the beginning of a contraction to the end of that same contraction, expressed in seconds.

Oxytocin (Pitocin)

A potent uterotonic medication released by the posterior pituitary that is high-alert and only administered IVPB prior to birth.

Gynecoid

One of the four types of bony pelves; considered the most common shape.

Pelvic Mid-Pelvis

The narrowest part of the bony pelvis, corresponding to a '$0$' station when the fetal head arrives.

Cephalic Presentation

Fetal presentation where the head enters the pelvis first, occurring in approximately $96\%$ of births.

Breech Presentation

Fetal presentation where the buttocks or feet enter the pelvis first, occurring in approximately $3\%$ of births.

Fetal Lie

The relation of the long axis of the fetus to the long axis of the mother, categorized as longitudinal (vertex) or transverse.

Fetal Attitude

The relation of fetal body parts to one another, typically general flexion.

Frank Breech

A type of breech presentation where the fetus's hips are flexed and knees are extended.

Leopold’s Maneuvers

A four-step process used to determine fetal presentation: assessing what's in the fundus, the location of the back, identifying the presenting part, and finding the cephalic prominence.

Anterior Fontanel

The 'soft spot' on the fetal skull that typically closes around $16-18\,months$ of age.

Posterior Fontanel

The smaller 'soft spot' on the fetal skull that typically closes around $3\,months$ of age.

Moulding

The process where the bones of the fetal skull move and override each other to allow the head to fit through the birth canal.

Placenta Previa

A condition where the position of the placenta impedes the progress of the fetus through the birth canal.

SROM

Spontaneous Rupture of Membranes, also known as the 'bag of water' breaking.

Nitrazine Paper

A test used to confirm the rupture of membranes by checking the pH of the fluid.

Fern Test

A test used to confirm the rupture of membranes by observing a branching pattern under a microscope.

Amniotomy

The artificial/punched rupture of the amniotic sac to facilitate labor.

Catecholamine

A stress hormone that increases during labor and can influence the perception of pain.

Beta-endorphins

Natural chemicals in the body associated with euphoria and analgesia during the labor process.

Morphine

A sedative/analgesic used for pain in early vs. active labor; dose is $5mg-10mg\,IM$.

Fentanyl

A rapid-onset narcotic with rapid clearance used in active labor; dose is $50mcg-100mcg\,IVP$.

Promethazine

A medication used for nausea that potentiates morphine; dose is $12.5-25mg\,p.o.\text{ or }IM$, and it is NEVER given IV push.

Ondansetron

An anti-emetic with no sedation properties used for labor comfort; dose is $4-8mg\,IVP\text{ or }p.o.$.

Epidural Anesthesia

A regional block delivered via a fine tube in the epidural space, usually consisting of ropivacaine and fentanyl.

Post-epidural Hypotension

The primary side effect of an epidural, necessitating an IV fluid bolus prior to placement.

Pudendal Block

A regional anesthesia block placed by an OB or midwife using lidocaine just before delivery.

Normal Fetal Heart Rate Range

The baseline fetal heart rate sustained between $110-160\,bpm$.

Fetal Bradycardia

A fetal heart rate baseline of less than $110\,bpm$.

Fetal Tachycardia

A fetal heart rate baseline of greater than $160\,bpm$.

Variability

Fluctuations in the FHR baseline that are irregular in amplitude and frequency, predictive of normal fetal acid-base balance.

Moderate Variability

A reassuring sign where the fetal heart rate fluctuations range from $6\text{ to }25\,bpm$.

Ferguson Reflex

The maternal urge to push during the second stage of labor.

Laboring Down

The physiologic or 'passive' second stage where the patient avoids active pushing until the fetus has descended further.

Episiotomy

An incision (midline or mediolateral) made to facilitate delivery, though it is not used routinely.