What are the 5 P’s of labor?
Passageway, Passenger, Powers, Position, Psychological response
What is the passageway in the context of labor?
Birth canal
What are the components of the pelvic bony structure?
4 bones joined by 4 joints
What hormone relaxes the joints of the pelvis?
Relaxin
Name the three parts of the pelvic passage.
Inlet, Midpelvis, Outlet
What forms the pelvic floor?
Pelvic tissues and ligaments
What happens to the perineum during labor?
Thins to 1 cm
What nerve roots carry sensory fibers related to pain during labor?
T11, T12
What are the theories for the cause of pain during labor?
- Hypoxia of myometrium
- Compression of nerve ganglia
- Stretching of cervix
- Stretching of peritoneum
What factors affect pelvic blood supply during labor?
- Tone
- Contractility
- Arterial perfusion pressure
- Venous overflow
What is the ‘lie’ in obstetrics?
Relationship of long axis of baby to long axis of mother
What are the two types of fetal lie?
Longitudinal, Transverse
What does presentation refer to in the context of labor?
Part of fetus foremost in birth canal
List the types of fetal presentation.
- Head
- Occiput
- Face
- Brow
- Breech (Frank, Complete, Footling)
What does the term ‘station’ refer to?
Degree of descent of presenting part into the birth canal
What physiological and hormonal changes occur towards the end of pregnancy?
- Increase in prostaglandins
- Increase in estrogen and oxytocin
- Decrease in progesterone
What are the characteristics of contractions?
- Intensity (Mild, moderate, strong)
- Frequency (every 2-4 minutes)
- Duration (lasting 60 seconds)
What is the lithotomy position?
Position for birth
What are the emotional phases during labor?
- 0-3 cm
- 4-7 cm
- 8-10 cm
What are the stages of labor?
- First stage: 0-10 cm
- Second stage: bearing down until birth of infant
- Third stage: delivery of infant until expulsion of placenta
- Fourth stage: immediate postpartum period (1-2 hours)
Define the second stage of labor.
10 cm to birth
What are the signs of the second stage of labor?
- Urge to push (Ferguson’s reflex)
- Defecation
- Bulging of the perineum
- Increased rectal and perineal pressure
- Increased bloody show
- Involuntary grunting
What are the phases of the second stage of labor?
- Early
- Active or descent phase
What are the cardinal movements during labor?
- Descent
- Flexion
- Internal rotation
- Extension
- Restitution
- External rotation
- Lateral flexion
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Skin Assessment19
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HEENT29
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Gestational Age20
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Abdominal & Genitourinary33
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Fetal Monitoring28
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L&D26
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Sepsis38
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CBC37
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Transition to Extrauterine Life56
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Pregnancy Physiology29
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Neurologic24
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Differential Diagnosis16
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Hematology43
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Glucose Management29
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Hyperbilirubinemia44
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Late preterm19
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Pneumonia14
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TTNB16
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Blood gases35
