N113 - Labor & Delivery
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| What are the 4 P's impacting labor & birth? | show 🗑
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| show | Size & type of pelvis, ability of cervix to dilate & efface, ability of vagina to distend.
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| How does the passenger affect labor & birth? | show 🗑
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| How does power effect labor & birth? | show 🗑
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| show | Physical preparation, sociocultural heritage, previous experience, support system, emotional integrity
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| show | Diagonal conjugate, true conjugate, obstetric conjugate, inlet & outlet.
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| show | The distance between the lower border of the symphysis pubis to sacral promontory. Should be >11.5 cm for pelvic inlet to be adequate. Measured by hand during pelvic exam.
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| show | Distance from upper border of symphysis pubis to middle of sacral promontory, determined by subtracting 1 cm from the diagonal - estimated, cannot be measured.
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| What is the obstetric conjugate? | show 🗑
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| show | The upper border of the true pelvis, transverse diameter of the true pelvis is the largest.
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| What is the outlet? | show 🗑
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| show | Gynecoid or round, 50% of females have this type
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| What is the most favorable type of pelvis? | show 🗑
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| show | Android or heart shaped, platypelloid or flat
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| show | The relation of fetal parts to one another. Normal is flexion of head, arms to chest, legs to abdomen, classic fetal position.
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| show | Relation of long axis (spine) of the fetus to that of the mother. Normal is longitudinal, transvers is when baby is laying across the abdomen.
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| show | What part is first in the maternal pelvis.
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| What is cephalic presentation? | show 🗑
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| What are the different types of cephalic presentation? | show 🗑
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| show | Trauma to neck, trachea, & larynx, facial edema, detected by palpating fontanelle, anterior fontanelle will be felt instead of posterior.
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| What are the risks associated with face presentation? | show 🗑
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| show | Decreased weight of baby, increased mortality & anomalies, more common with placenta previa, multiple gestation & grand multiparity. Possible head entrapment, increased chance of cord prolpse. Passage of merconium due to compression of intestines.
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| What are the 3 types of breech presentation? | show 🗑
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| What is a shoulder presentation? | show 🗑
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| What is engagement? | show 🗑
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| show | Relationship of presenting part to imaginary line drawn between the ischial spines, graded at + or -.
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| What is fetal position? | show 🗑
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| show | O - Vertex or occiput - normal fetal position, M - face, chin or mentum presenting, S - breech, sacrum presenting, A - shoulder, scapula or acromion process presenting.
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| show | Engagement & descent, flexion, internal rotation, extension, external rotation, expulsion.
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| What is engagement & descent? | show 🗑
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| What is flexion? | show 🗑
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| What is internal rotation? | show 🗑
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| What is extension? | show 🗑
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| What is external rotation? | show 🗑
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| show | Extension, external rotation & expulsion
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| What are the 3 stages of a contraction? | show 🗑
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| How is the frequency timed? | show 🗑
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| How is the duration calculated? | show 🗑
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| How is intensity rated? | show 🗑
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| How is the latent phase characterized? | show 🗑
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| show | Cervical dilation from 4-8 cm, contraction stronger & longer, more frequent, more painful, Mother needs to use breathing techniques, pain medication is usually administered
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| How is the transition phase characterized? | show 🗑
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| show | This is when the mom feels the need to push, doctor may do episiotomy at this time, contractions are less painful since cervix is completely dilated
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| show | Birth of baby and delivery of placenta, mother is exhausted and eager to see baby, very hungry & thirsty.
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| show | This is the first hour post partum
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| show | There is no change in the cervical consistency in false labor.
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