Nurs 114 Unit 3 Study Guide
a. Not completely understood; triggered by maternal and fetal factors
b. Maternal Factors:
i. Stretching of uterine muscles, estrogen/progesterone changes, oxytocin releases,
release of prostaglandins
i. Fetal cortisol changes (produced by fetal adrenal glands), placenta ages
(deuterates), prostaglandins increase causing contractions
a. 24 weeks (most believe it is this, but some think 22-24 weeks)
a. Lightening, Braxton hicks, cervical changes (softens/ripened), nesting (cleaning
everything/increased energy), weight loss, low backache, release of mucus plug, bloody
show
a. True labor
i. Contractions make cervical changes
ii. Contractions increase in frequency and intensity
iii. Causing effacement and dilation
b. False labor
i. Irregular contractions with little or no cervical changes
ii. Activity doesn't change pattern; hydration or sedation slows/stops ctxs
a. 1 time moms come in when contractions are 5 minutes apart and lasting 1 minute
b. A lot of factors play into this time so it varying. The more babies you have the faster your
labor is.
a. The essential components of the outcome of labor
b. Powers
i. Uterus contractions
1. Myometrium contracts and shortens
a. Upper segment contract to push fetus down
a. Its less active because its allows the cervix to thin
a. Dilation and effacement
a. Opening of cervical os
i. Goes from closed to 10cm (complete or fully dilated)
a. Thinning (shortening of cervix from 0% to 100%)
i. 100% is paper thin
, i. Sterile uterine exam
i. Rhythmic and intermittent
a. Allows blood flow to the uterus and
placenta that was temporarily reduced
during contraction (when nutrients,
gasses, wastes are exchanged)
1. Frequency:
a. Beginning of one contraction to the
beginning of another
2. Duration
a. Beginning of contraction to the end of
the same contraction
3. Intensity
a. Strength of contraction (mild,
moderate, strong)
i. Top is fetal heart rate; bottom is the contractions
ii. Every 6 boxes equals 1 minute (the darker lines =
1minute
c. Passage
i. Pelvis (page 223 figure 8-4)
1. Gynecoid, android, anthropoid, platypelloid
i. Gynecoid
i. Platypelloid
1. Estrogen and Relaxin soften cartilage and increase elasticity of the
ligaments
1. Station: (3rd important key factor)
a. Relationship of the ischial spines to the presenting part of the
fetus (tells us how far down the baby is
1. Cm
i. 0 station
, i. -3 station
2. Floating:
a. No engagement (not engaged into the pelvis)
a. 3 cm dilated, 50% effaced (or thinned), -1cm above the ischial
spine
1. Helps the fetus rotate in correct position through the canal
1. Expands to allow passage
d. Passenger
i. Baby and relationship to the passageway
1. Skull, attitude, lie (laying), presentation (what part of the baby is coming
out first), position, size
1. Cone shaped head
1. Sutures
a. Membranous space between the bones
2. Fontanels
a. Intersections of these sutures
b. Anterior and posterior fontanels
i. They play a key role in the baby being able to move and
shift
a. Yes.
a. The biparietal which is 9.25 cm
a. Posture the relationship of fetal parts to one another
a. The vertex position (chin to chest, neck is flexed down, head
down)
a. The way the baby is laying in the mother
a. Longitudinal (long axis of fetus and mother parallel
i. This baby would not be able to be delivered vaginally
a. First body part that enters the pelvic inlet "presenting part"
, i. Helps us determine if the vaginally delivery will be
successful or if c-section is required
1. Cephalic
a. Head first
2. Breech
a. Pelvis first
3. Shoulder
a. Shoulder first
a. Vertex, brow, Face presentations Page 225
a. Complete breech, frank breech, single footing breech
12. Make copies of pictures and do flashcards
1. Relationship of fetal presenting part to maternal pelvis
a. By looking at the presenting fetal part
a. (O) Occipital bone
i. vertex presentation
b. (M) Mentum
i. face presentation
c. (S) Sacrum
i. breech presentation
d. (A) Acromion
i. shoulder presentation
1. Using three letters
a. First letter
i. Location of presenting part to the Left (L) or Right (R) of
maternal pelvis
b. Second letter
i. Specific fetal part presenting
c. Third
i. Relationship of the presenting part to the maternal
pelvis such as anterior (A) posterior (P), transverse (T)
a. OA
a. OP which makes for a difficult delivery
a. Not completely understood; triggered by maternal and fetal factors
b. Maternal Factors:
i. Stretching of uterine muscles, estrogen/progesterone changes, oxytocin releases,
release of prostaglandins
i. Fetal cortisol changes (produced by fetal adrenal glands), placenta ages
(deuterates), prostaglandins increase causing contractions
a. 24 weeks (most believe it is this, but some think 22-24 weeks)
a. Lightening, Braxton hicks, cervical changes (softens/ripened), nesting (cleaning
everything/increased energy), weight loss, low backache, release of mucus plug, bloody
show
a. True labor
i. Contractions make cervical changes
ii. Contractions increase in frequency and intensity
iii. Causing effacement and dilation
b. False labor
i. Irregular contractions with little or no cervical changes
ii. Activity doesn't change pattern; hydration or sedation slows/stops ctxs
a. 1 time moms come in when contractions are 5 minutes apart and lasting 1 minute
b. A lot of factors play into this time so it varying. The more babies you have the faster your
labor is.
a. The essential components of the outcome of labor
b. Powers
i. Uterus contractions
1. Myometrium contracts and shortens
a. Upper segment contract to push fetus down
a. Its less active because its allows the cervix to thin
a. Dilation and effacement
a. Opening of cervical os
i. Goes from closed to 10cm (complete or fully dilated)
a. Thinning (shortening of cervix from 0% to 100%)
i. 100% is paper thin
, i. Sterile uterine exam
i. Rhythmic and intermittent
a. Allows blood flow to the uterus and
placenta that was temporarily reduced
during contraction (when nutrients,
gasses, wastes are exchanged)
1. Frequency:
a. Beginning of one contraction to the
beginning of another
2. Duration
a. Beginning of contraction to the end of
the same contraction
3. Intensity
a. Strength of contraction (mild,
moderate, strong)
i. Top is fetal heart rate; bottom is the contractions
ii. Every 6 boxes equals 1 minute (the darker lines =
1minute
c. Passage
i. Pelvis (page 223 figure 8-4)
1. Gynecoid, android, anthropoid, platypelloid
i. Gynecoid
i. Platypelloid
1. Estrogen and Relaxin soften cartilage and increase elasticity of the
ligaments
1. Station: (3rd important key factor)
a. Relationship of the ischial spines to the presenting part of the
fetus (tells us how far down the baby is
1. Cm
i. 0 station
, i. -3 station
2. Floating:
a. No engagement (not engaged into the pelvis)
a. 3 cm dilated, 50% effaced (or thinned), -1cm above the ischial
spine
1. Helps the fetus rotate in correct position through the canal
1. Expands to allow passage
d. Passenger
i. Baby and relationship to the passageway
1. Skull, attitude, lie (laying), presentation (what part of the baby is coming
out first), position, size
1. Cone shaped head
1. Sutures
a. Membranous space between the bones
2. Fontanels
a. Intersections of these sutures
b. Anterior and posterior fontanels
i. They play a key role in the baby being able to move and
shift
a. Yes.
a. The biparietal which is 9.25 cm
a. Posture the relationship of fetal parts to one another
a. The vertex position (chin to chest, neck is flexed down, head
down)
a. The way the baby is laying in the mother
a. Longitudinal (long axis of fetus and mother parallel
i. This baby would not be able to be delivered vaginally
a. First body part that enters the pelvic inlet "presenting part"
, i. Helps us determine if the vaginally delivery will be
successful or if c-section is required
1. Cephalic
a. Head first
2. Breech
a. Pelvis first
3. Shoulder
a. Shoulder first
a. Vertex, brow, Face presentations Page 225
a. Complete breech, frank breech, single footing breech
12. Make copies of pictures and do flashcards
1. Relationship of fetal presenting part to maternal pelvis
a. By looking at the presenting fetal part
a. (O) Occipital bone
i. vertex presentation
b. (M) Mentum
i. face presentation
c. (S) Sacrum
i. breech presentation
d. (A) Acromion
i. shoulder presentation
1. Using three letters
a. First letter
i. Location of presenting part to the Left (L) or Right (R) of
maternal pelvis
b. Second letter
i. Specific fetal part presenting
c. Third
i. Relationship of the presenting part to the maternal
pelvis such as anterior (A) posterior (P), transverse (T)
a. OA
a. OP which makes for a difficult delivery
