Term
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Definition
progresses more rapidly than expected
often associated with frequent occuring contractions associated with oxytocin over stimulation, chorioamniontis, or placental abruption (not enough blood flow) |
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Term
|
Definition
laboring patients that progress slower than normal
difficult labor or childbirth
usually related to one of the 3 P's power passenger passage |
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Term
|
Definition
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Term
|
Definition
cease to progress in labor
no cervical change |
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Term
|
Definition
cephalopelvic disproportion
fetal size and maternal pelvic size not compatiable
type of arrest disorder |
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Term
| what are the 3 abnormal labor patterns |
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Definition
prolonged latent phase
protraction disorders
arrest disorder |
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Term
| define prolonged latent phase |
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Definition
>20h for nulligravidas
>14h for multiparas |
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Term
| define protracton disorder |
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Definition
| prolonged active phase or labor |
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Term
| how to qualify protraction disorder |
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Definition
cervical dilation///
<1.2cm for nilligravidas
<1.5 cm for multiparas
descent of presenting part
<1cm for nulligravidas
<1.5cm for multiparas |
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Term
| what are the two arrest disorders, define each |
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Definition
secondary arrest dilation: no cervical dilation for >2h in active phase
arrest/descent: no descent in presenting par in >1h in second stage of labor |
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Term
| two types of fetal monitoring 3 |
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Definition
tocodynamometer: records force of contraction and frequency
uttering doppler: gets : screw metal into babys head |
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Term
| fetal problems resultting in dystocia 4 |
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Definition
fetal weight
fetal head position and attidude
malpresentation
fetal anomalies |
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Term
| what are the types of fetal head position and attitude 6 |
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Definition
asynclitic
brow
face
persistent occiput posterior; facing up, ok for vaginal
mentum posterior: cannot vaginal
mentum anterior: can vaginal, but difficult |
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Term
| 3 types of fetal malpresentation |
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Definition
comoiund: baby is trying to bring limbs out with its head (push them in)
transverse lie
breech |
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Term
| 2 fetal anomalies that can cause dystocia |
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Definition
hydrocephalus
fetal tumors |
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Term
| 5 materal conditions causing dystocia |
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Definition
bony pelvis
distended bladder
colon masses
axnedial masses: mass on ovary
fibroids: tumors in uterine muscle, all benign |
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Term
| 4 types of pelvis and their prognosis for delivery |
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Definition
android: most common reason for arrest disorders
gynecoid: round, baby comes out good
antrhopoid: undetermined
platypelloid: thin, baby dosent fit, some babies can go sideways |
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Term
| how is dystocia categorized |
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Definition
| prolongation and arrest disorders |
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Term
| defne nulliparous prolonged latent phase |
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Definition
|
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Term
| define multiparous prolonged latent phase |
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Definition
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Term
| define nulliparous prolonged active phase |
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Definition
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Term
| define multiparous prolonged active phase |
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Definition
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Term
| how can abnormal labor be managed |
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Definition
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Term
| define induction of labor |
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Definition
| stimulation of labor before the onset of contractions via pitosin |
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Term
| define augmentation of labor |
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Definition
| stimulation of labor contractions that are infrequent or ineffective in intensity |
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Term
|
Definition
monotevifro units
number of uterine contractionsin 10 min x ineensity
>200 is normal labor progression |
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Term
| what does bishop score evaluate |
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Definition
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Term
| what gets 0 points in a bishop score |
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Definition
dilation: closed
effacement: 0-30%
station: -3
consistency: firm
prosition: posterior |
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Term
| what gets 1 point in bishop score |
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Definition
dilation: 1-2cm
effacement: 40-50%
station: -2, -1
consistency: medium
prosition: mid |
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Term
| what gets 2 points in bishop score |
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Definition
dilation: 3-4cm
effacement: 60-70%
station: 0
consistency: soft
prosition: anterior |
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Term
| what gets 3 points in bishop score |
|
Definition
dilation: 5cm+
effacement: 80%+
station: 1,2 |
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Term
| what does a bishop score of 0-4 indicate, what tx can you do (4) |
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Definition
induction not successful
ropening of cervix prostiglandins E2 gel
cytotex: sea weed forces cervix top open in 1-2d
foley bulb: put baloon n cervix and force it open
lanubara: pill that goes in vag every 4h to ripen |
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Term
| what does bishop score 9-13 mean |
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Definition
| induction likley successful and will have vaginal delivery |
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Term
|
Definition
post-term pregnancy
maternal medical problems: DM, heart disease
fetal demise
suspected fetal compromise
pregnancy induced HTN (pre-eclampsia)
premature rupture of membranes
chorioamnionitics |
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Term
| contractions to labor induction 7 |
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Definition
placenta or vasa previa
cord presentation
abnormal/unstable fetallie
presenting part about inlet
prior classical uterine incision in active muscle
posterior uterine incision of unk type
active genital herpes |
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Term
| how can you tell a contraction in false and true labor apart |
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Definition
| pain meds take away false |
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Term
|
Definition
placenta is covering entire opening of cervix forcing baby
could cause bleed or vessel previa
vessels cross opening of cervix and baby could bleed out |
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Term
| true labor contractions: intervals, duration, intensity, cervix, location of pain, tx |
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Definition
interval: regular
duration: gradually increasing
cervix: dilating
location: back and abd
tx: sedation does not relieve |
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Term
| false labor contractions: intervals, duration, intensity, cervix, location of pain, tx |
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Definition
interval: irregular
duration: irregular
cervix: no dilation
location: lower abd
tx: sedation does relieve |
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Term
| when is prolonged second stage (active stage) too long |
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Definition
two hour is normal, esp for atypical presentations
OP may be longer but not to exceede 3h
if mom is tolerating and fetal heart is reassuring then more time may be allowed |
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Term
| risks of prolonged labor to mom |
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Definition
infection
maternal exaustion
lacerations
uterine atony
operative delivery: vaccum/forceps cause soft tissue injury and fetal trauma |
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Term
|
Definition
| uterus does not contraction to constrict vessels after birth causing hemorrhage |
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Term
| risks of prolonged labor to baby |
|
Definition
asphyxia: not enough O2
trauma from difficult deliveries
infection
meconium aspiration: resp distress due to 2 mechanical obstruction and chemical pneumpnitis |
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Term
| tx for mechnoium aspiration 3 |
|
Definition
aminofusion in utero
suction catheter at birth
ET suction |
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Term
| frequency of breech presentation |
|
Definition
2% of single pregnancies at term
more frequent in premature births |
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Term
| causes of breech presentation 8 |
|
Definition
prematurity: more amniotic fluid, baby is smaller, flipping
multiple pregnancies
polyhydraminos
hydrocephaly
anecephaly: no brain/top of head
aneuploidy: cant move wekk
uterine anomalies
uterine tumor/fibrosis |
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Term
| 3 types of breech presentations |
|
Definition
frank breech: hips flexed, knees extended, feet by head
complete breech: hips and knes flexed
incomplete breech: single foot hanging down |
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Term
| what is external cephalic version, who can get it, what is the concern |
|
Definition
turning baby manually
allowed in normal fetus, normal heart tracing, sdequate AFI, no uterine scars, presenting part not in the pelvis, after 37 wks (could break water, and begin delivery)
it is painful |
|
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Term
| how to deliver a breech fetus <2000 GMS |
|
Definition
C section 2 to risk of birth injury
pulling on baby can cause brain bleed |
|
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Term
| how deliver a breech fetus >3800 GMS |
|
Definition
| c section 2 to risk of entrapment of larger fetal head when baby comes out feet first |
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Term
| how to deliver a 2000-3800 GMS |
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Definition
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Term
|
Definition
total breech extraction: entire body extreacted, youll pull it out yourself
partial breech extraction: let mom push baby all the way up to belly button, less trauma on her and baby
spon breech delivery: no traction or manipulation on the fetus, delivers spontaneously |
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Term
| how to do a breech extraction |
|
Definition
gentile traction on feet, ankles, thighs, pelvis
gentile traction and rotation as scapulae become visible sweeping the posterior then anterior arm free in process
mariceau maneuver: to deliver head |
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Term
| conditions for forceps application |
|
Definition
cervix: fully dilated, ripping cervix causes lots of bleeding
membranes; ruptured
positions and station of fetal head: known and engaged
anesthesia: adequate for maternal comfort
maternal pelvis: evaluated and found appropirate |
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Term
|
Definition
|
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Term
| outlet forceps: when do use, how to use |
|
Definition
| fetal skull has reached perineal floor, scalp is visible between contractions, saggital suture is AP diameter or in right/left occiput ant/post position, no more than 45 deg from midline |
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Term
|
Definition
| leading edge of skull is +2 station or more |
|
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Term
|
Definition
| head is engaged but leading edge of skull is above +2 station |
|
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Term
| when can you do vaginal birth after C section |
|
Definition
allowed to have up to 2 C sections before not allowed to do vaginal delivery
1% risk of uterine rupture which is 50% mortality to baby |
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Term
| complications of uterine rupture |
|
Definition
fetal bradycardia
loss of intrauterine pressure
pain: can be masked by epidural
increased bleeding
movement of persenting fetal part of pelvis |
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