What are the maternal responses to labor? - Answers Intermittent contractions of the upper
uterus to push fetus down and maintain placental perfusion; forms a retraction ring
cervix effaces and dilates
What are the fetal responses to labor? - Answers placenta maintains reserves for perfusion
during contractions; CV system reacts quickly; fetal lung fluid decreases as thoracic
compression encourages its expulsion
Four P's of Labor - Answers Powers
Passage
Passenger
Psyche
What are the two components of Powers of labor? - Answers contractions (1st stage) from
onset to dilation
pushing (2nd stage) from dilation to birth
Passage - Answers maternal pelvis and soft tissues
pelvis: does not readily yield to the forces of labor; linea terminalis must be wide enough for
fetus to pass through (gynecoid shape) or cephalopelvic disproportion results.
soft tissues: relaxin softens cartilage link of the pelvis and surrounding tissues/ligaments
What is the largest part of the fetus? - Answers Head
Fetal Lie - Answers The relationship between fetal maternal spine
Ideal: lateral
Problematic: transverse
Fetal attitude - Answers Flexion (preferred) or extension
Presentation - Answers Which part of the fetus is closest to the cervis
Ideal: cephalic (vertex) = head down
, other:
- brow (forehead against cervix)
- face (face against cervix)
- breech (footling, double footling, frank)
Psyche - Answers circumstances/experiences may increase catecholamines which decrease
UC/placental perfusion and increase pain
It's important to promote relaxation
Premonitory signs of labor - Answers Braxton-Hicks, Lightening, Bloody Show, Nesting,
Spontaneous Rupture of Membranes (SROM)
True Labor - Answers regular and consistent contractions that increase in intensity, duratrion,
and frequency
contraction pain begins in the back and wraps around to the front; worsened by walking
cervix dilates and effaces
False Labor - Answers contractions are inconsistent in frequency, duration, and intensity
annoying pain in the abdomen/groin that disappears with walking
no cervical changes
What is an expectation for multiparous patients? - Answers Their labors will be shorter the more
deliveries they have had
Signs of Impending Birth - Answers grunting, bearing down, "The Baby is Coming!"
First Stage of Labor - Answers Cervix dilates and effaces
Latent: 0-5cm; longer in nullipara
Active: 6-10cm; null = 8-10 hrs and multi = 5-7 hrs
Assessments for the first stage of labor - Answers Fetal Monitoring, contractions, sterile
cervical exams, status of membranes, pain, I+Os, support person status
Second Stage of Labor - Answers Birth
Assessments for the second stage of labor - Answers Signs of complications,
maternal/neonatal VS, Apgar, weight/height of neonate