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Intrapartum
Reproduction: Intrapartum
| Question | Answer |
|---|---|
| Intrapartum | Period starts at onset of contractions and extends to the first 1-4 hours after birth of the neonate and delivery of the placenta |
| Premonitory/Preliminary Signs of Labor | -Cervical changes (cervical softening, possible cervical dilation) -Lightening -Increased energy level (nesting) -Braxton hicks contractions |
| True Signs of Labor | -Bloody show -Spontaneous rupture of membranes, painful contractions, effacement and dilation |
| Critical Factors Affecting Labor and Birth | -Powers (contractions) -Passageway (birth canal: pelvis & soft tissues) -Passenger (fetus and placenta) -Psychological response (mom's emotional state) |
| Additional Factors Affecting the Labor Process | -Philosophy (low-tech, high-touch) -Partners (support caregivers) -Patience (natural timing) -Patient preparation (childbirth knowledge base) -Pain control (comfort measures) |
| Factors Determining Fetal Presentation | ALPPPS -Attitude -Lie -Presentation -Presenting part -Position -Station |
| Attitude | -Flexion: normal attitude (head flexed down with chin to chest) -Extension: abnormal attitude (head extended back) |
| Lie | Relationship of fetal spine to maternal spine -Longitudinal: normal lie, both spines are parallel -Transverse: both spines form cross, c-section required -Oblique: the fetal spine is at angel to the bony inlet and no palpable fetal part is presenting |
| Presentation | -Cephalic (head): vertex, brow, face (mentum), sinciput -Breech (butt): Frank, cull/complete, footling, kneeling, incomplete -Shoulder: all transverse lies are considered shoulder |
| Presenting Part | The term used describe which part of the baby will lead the way out of the birth canal -Head -Shoulder -Side -Foot -Abdomen |
| Position | Used to describe baby position in relation to mom -Right or Left -Presenting part -Anterior or posterior |
| Landmarks | -Occiput: back of the head (most common presenting part) -Scapula -Sacrum -Mentum: chin |
| Most common position | - Left occiput anterior (LOA) |
| Station | How far down the baby is in the birth canal in relation to mom's ischial spine -Ischial spine is 0 -Negative #s mean baby is farther inside (-1, -2) -Positive #s means baby is closer to delivery (+!, +2) -Station +4 known as crowning |
| Engagement | When the presenting part of the fetus passes into the pelvis to the point where, in cephalic presentation, the fetal head is at the ischial spine (0 station) |
| Descent | When the head passes the ischial spine and moves into the pelvic inlet |
| Internal Rotation | Consist of a turning of the head in such a manner that the occiput gradually moves toward the symphysis pubis anteriorly |
| External Rotation (Restitution) | Corresponds to the rotation of the fetal body and serves to bring its bisacromial diameter into the relation with the AP diameter |
| First Stage of Labor | -Cervical dilation (ends at 10 cm) -Longest of all stages -Three phases: latent phase, active phase, transition phase |
| Second Stage of Labor | -Cervix is dilated to 10 cm -Ends with delivery of the fetus |
| Third Stage of Labor | -Starts immediately after baby is born -Placental separation -Ends with placental expulsion |
| Fourth Stage of Labor | -Begins after delivery of placenta -1 to 4 hours following delivery -Monitor for hemorrhage, bladder distention, and venous thrombosis |
| Physiological Responses to Labor | -^ heart rate, cardiac output, BP -^WBC count -^RR and O2 consumption -Decrease gastric motility, gastric emptying -Muscle aches/cramps -^BMR -Decrease blood glucose levels |
| Variable Deceleration | An abrupt visual decrease in the FHR by at least 15 bpm that lasts >15 seconds <2 mins and not associated to contractions -Cord Compression |
| Early Deceleration | Gradual visual decrease from and return of the FHR to baseline associated with a uterine contraction that matches the contraction -Head Compression |
| Accelerations | Abrupt visual increase in the FHR; Represents adequate fetal oxygenation -Okay! |
| Late Decelerations | Gradual visual decrease from and return to baseline associate with uterine contraction, but lowest point of the deceleration occurs after the peak of contraction -Placental insufficiency |
Created by:
NikkiLeigh83
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