normal labor

Question 1

physiological changes before labor (only the names)

Answer 1

1. lightening
2. Braxton-Hicks contractions
3. Bloody show

Question 2

physiological changes before labor - lightening

Answer 2

fetal descent into the pelvic brim

Question 3

physiological changes before labor - Braxton-Hicks contractions

Answer 3

benign contraction that do not result in cervical dilation. They routinely start to increase in frequency towards the end of the pregnancy

Question 4

physiological changes before labor - Bloody show

Answer 4

blood-tinged mucus from vagina that is released with cervical effacement

Question 5

stage of labor - only names

Answer 5

1. stage 1
2. latent phase
3. active phase
4. stage 2
5. stage 3

Question 6

stage of labor - stage 1 (when and duration)

Answer 6

onset of labor –> full cervical dilation

primigravid: 6-18 h
multipara: 2-10 h

Question 7

stage of labor - latent phase (when and duration)

Answer 7

onset of labor –> 4 cm dilation

primigravid: 6-7 h
multipara: 4-5 h

Question 8

stage of labor - active phase (when and duration)

Answer 8

4 cm dilation –> full dilation (10 cm)

primigravid: 1 cm per hour
multipara: 1.2 cm per hour

Question 9

stage of labor - stage 2 (when and duration)

Answer 9

full dilation of cervix and mother wants to push –> delivery of neonate

primigravid: 30 mins - 3 h
multipara: 5-30 mins

Question 10

stage of labor - stage 3 (when and duration)

Answer 10

delivery of neonate –> delivery of placenta

30 mins

Question 11

stage of labor - stage 1 (monitoring)

Answer 11

monitor: 1. maternal BP and Pulse
2. electronic fetal monitor (fetal HR and uterine contractions)
3. examine cervix to monitor the progression of labor for
a. cervical dilation
b. effacement
c. station: where the fetus’s fead is located in relationship to pelvis (measured -3 through +3)

Question 12

stage of labor - stage 2 - the progression of this stage is determined by

Answer 12

the rate of fetal head descent

Question 13

stage of labor - stage 2 - steps

Answer 13

1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. external rotation
7. delivery of anterior shoulder
8. delivery of posterior shoulder

Question 14

stage of labor - stage 2 - steps - engagement

Answer 14

fetal head enters the pelvis occiput first

Question 15

stage of labor - stage 2 - steps - descent

Answer 15

• progresses as uterine contraction and maternal pushing over
• descent continues until the fetus is delivered

Question 16

stage of labor - stage 2 - steps - flexion

Answer 16

fetal head flexion

Question 17

stage of labor - stage 2 - steps - internal rotation

Answer 17

1. when fetus head reaches the ischial spines, the fetus starts to rotate
2. rotation moves the sagital sutures into forward

Question 18

stage of labor - stage 2 - steps - extension

Answer 18

occurs so that the head can pass through vagina (oriented forward and upward)

Question 19

stage of labor - stage 2 - steps - external rotation

Answer 19

• during fetal head delivery, external rotation occurs, giving the shoulders room to descend
• anterior shoulder goes under the pubic symphisis first

Question 20

stage of labor - stage 2 - steps - delivery of anterior shoulder

Answer 20

gentle downward pressure on the fetal head will aid in delivery of anterior shoulder

Question 21

stage of labor - stage 2 - steps - delivery of posterior shoulder

Answer 21

• gentle upward pressure on the fetal head will aid in delivery of posterior shoulder
• the rest of the fetus will follow

Question 22

stage of labor - stage 3 - definition

Answer 22

immediately after delivery, inspect and repair lacerations of the vagina while waiting for placental separation

Question 23

stage of labor - stage 3 - signs of placental separation

Answer 23

1. fresh bleeding from vagina
2. umbilical cord lengthening
3. uterine fundus rising
4. uterus becoming firm

Question 24

induction of labor - medications (only names)

Answer 24

1. prostagladin E2
2. oxytocin
3. amniotomy

Question 25

induction of labor - prostagladin E2

Answer 25

cervical ripening | NOT IN ASTHMATIC PATIENTS

Question 26

induction of labor - oxytocin

Answer 26

exaggerates uterine contraction

Question 27

induction of labor - amniotomy

Answer 27

- puncture of the amniotic sac via amnio hook | - inspect for prolapsed umbilical cord before puncturing

Question 28

false lavor vs latent labor

Answer 28

- false labor, weak, irregular and infrequent contractions, none or mild pain, no cervical change - latent labor: regular, increasing frequency, increasing intenisty, with pain and cervical pain

Question 29

oxytocine toxicity

Answer 29

1. tachysystole 2. low Na2+ 3. hypotension

Question 30

common SE of epidural anesthesia (and mechanism)

Answer 30

hypotension (pooling of blood in venous from sympathetic blockage responsible for the vessels) it can results to fetal hypoxia and acidosis prevented by IV fluids, repositioning, vassopressors