Midwifery Midterm Exam 2025

Lie - -the relationship of the long axis of the fetus to the long axis of the uterus Attitude - -The relationship of the fetal head and limbs to the fetal trunk. Presentation - -The part of the fetus which lies in the lower segment of the uterus. Denominator - -A fixed point on the presenting part used to describe position. Position - -The relationship of a denominator to the quadrants of the maternal pelvis eg. left occipto anterior (LOA) Engagement - -The largest diameter of the presenting part has passed through the pelvic brim. Pelvic brim widest from side to side. At the level of the ischial spines 0 = engagement. Station - -refers to the level of presenting part in relation to the maternal ischial spines, whihc represent the narrowest diameter through which the fetus must pass, +stations indicates that the presenting part of the fetus has descended past the ischial spines. Mechanisms of labour - -Passive movements of the fetus as it passes through the birth canal, adapting to the shape of the maternal pelvis. Normal labour - -A process by which the fetus, placenta and membranes are expelled through the birth canal. normal labour begins spontaneously without intervention, with the fetus presenting by the vertex-duration 4-24hours. Pre term labour - -onset of labour before 37weeks of pregnancy. Antenatal period - -time of conception until the onset of labour. Post Partum/Puerperium - -the period taken for the reproductive organs to return to their pregravid state which is usually six weeks following childbirth Gravid - -pregnant Para - -this term is used to describe a woman who has produced one or more living children Parous - -a woman who has borne one or more viable offspring Primigravida - -a woman pregnant for the first time Midwifery Midwifery Multigravida - -a pregnant woman who has had previously more than one pregnancy. Grande Multigravida - -a woman in her fourth or subsequent pregnancy but who has not necessarily borne live children in previous pregnancies. Primipara - -a woman who has give birth to a viable infant, living or stillborn. Nullipara - -a woman who has never given birth to a viable child but may have been pregnant. Multipara - -a woman who has borne more than one viable infant Grand multipara - -a woman of high parity usually one who has borne 4 or more children Maternal morbidity - -illness or injury from the time of conception until the end of the puerperium and attributed to childbirth. Maternal mortality - -death from the time of cenception until the time completion of the puerperium and attributed to childbirth. Viable - -capable of independent life neonatal period - -pertains to the first four weeks after birth upper uterine segment - -the upper part of the uterus in pregnancy developed from the body. lower uterine segment - -lower part of the uterus in pregnancy developed from the isthmus and cervix braxton hicks contractions - -contractions in the uterus during pregnancy which are painless. retraction - -the process of permanent and pregressive shortening of the muscles of the uterus which accompanies contractions during labour- to dilate the cervix, to expel the fetus and to expel the uterus, membranes and to control bleeding. Physiological retraction ring - -the line of demarcation which develops at the junction of the upper and lower uterine segment in normal labour polarity - -co-ordination between the upper and lower uterine segments during normal labour fabourable/ripe cervix - -the cervix is soft and is considered favourable for labour Midwifery Midwifery effacement - -this refers to the thinning of the cervix in preparation for birth and is expressed in percentages. Mum needs to be 100% effaced to be able to push. Dilatation - -the extent to which the cervix has opened in preparation as a result of uterine contractions, full dilatation is 10cm. first stage of labour - -begins with the onset of labour until complete dilatation of the cervix second stage of labour - -from complete dilatation of the cervix until the birth of the infant third stage of labour - -from the birth of the infant until the placenta and membranes are delivered Fundal dominence - -The greatest strength of contractions occurs in the fundus of the uterus, moving down the upper segment in diminishing strength liquor - -amniotic fluid forewaters - -bag of membranes and liquor in front of the presenting part hindwaters - -liquor contained in the uterus behind the presenting part secondary powers - -abdominal muscles, diaphragm used to push in second stage of labour fetal axis pressure - -force of the fundal contraction is transmitted to the upper pole of the fetus down to the long axis of the fetus moulding - -alteration in the shape and diameteres of the fetal head during labour caput succedaneum - -occurs on the fetus scalp as a result of odema from obstructed venous return and pressure on the birth canal. lightening - -the presenting part enters the pelvis usually after 36weeks partograph - -provides graphical record of the progression of labour, particularly the dilatation of the cervix. progress can be assessed from the visual patterns of cervical dilatation and descent of the presenting part in conjunction with the record of the maternal and fetal wellbeing. involution - -return of the uterus to its pre-pregnant state crowning - -when the babys head has passed through the birth canal and the top or crown stays visible at the vaginal opening. Midwifery Midwifery progesterone - -acts on smooth muscles, promotes breast development and growth human chorionic gonadtrophin (hCG) - -secreted by trophoblast, stimules corpus luteum to produce oest/prog until placenta takes over. stops the mum rejecting the baby, values are present in maternal urine-pregnancy test, causes morning sickness human placental lactogen (hPL) - -begins 5-10days after implantation, facilitates growth, low levels are facilitated with miscarriage. bones of the pelvis - -2 innominate hip bones, one sacrum, one coccyx hip bone are made up of: - -illium (large flared out part), ischium (thick lower part) and pubic bone. ischial tuberosity - -is a large prominence when the body rests when sitting ischial spines - -lies above the ischial tuberosity, inward projections, situation of fetal head is estimated in terms of centimeters above or below. what are the joints of the pelvis - -one symphysis pubis, two sacroilliac joints and one sacrococcygeal joint. ligaments of the pelvis - -intepubic, sacroiliac, sacrococcygeal, sacrotuberous, sacrospinous. CTG - -fetal assesment, trace of fetal heart rate and maternal contractions. baseline CTG - -Normal FHR is 110-160, the mean level of the FHR at rest, in the absence of fetal movement, uterine activity, accelerations and decelerations. variability - -the minor fluctuations in baseline FHR of 5-25 beats in amplitude. Inteaction between parasympathetic and sympathetic nervous system. indeicates adequate fetal perfusion. the effects of decrease variability on the fetus is? - -CNS depression, deep fetal sleep, drugs, prematurity, hypoxia. accelerations - -the transient increase in FHR of 15bpm, or more above the baseline lasting at least 15seconds. decelerations - -decrease FHR below the baseline of more than 15bpm lasting at least 15seconds. may be early, variable, prolonged or late. BRIM - -anterior/posterior = 11, oblique = 12, transverse= 13 Midwifery Midwifery CAVITY - -anterior/posterior=12, Oblique =12, transvers = 12.