Term
|
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) |
|
|
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 |
|
|
Term
|
Definition
|
|
Term
|
Definition
cease to progress in labor no cervical change |
|
|
Term
|
Definition
cephalopelvic disproportion fetal size and maternal pelvic size not compatiable type of arrest disorder |
|
|
Term
what are the 3 abnormal labor patterns |
|
Definition
prolonged latent phase protraction disorders arrest disorder |
|
|
Term
define prolonged latent phase |
|
Definition
>20h for nulligravidas >14h for multiparas |
|
|
Term
define protracton disorder |
|
Definition
prolonged active phase or labor |
|
|
Term
how to qualify protraction disorder |
|
Definition
cervical dilation/// <1.2cm for nilligravidas <1.5 cm for multiparas
descent of presenting part <1cm for nulligravidas <1.5cm for multiparas |
|
|
Term
what are the two arrest disorders, define each |
|
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 |
|
|
Term
two types of fetal monitoring 3 |
|
Definition
tocodynamometer: records force of contraction and frequency uttering doppler: gets : screw metal into babys head |
|
|
Term
fetal problems resultting in dystocia 4 |
|
Definition
fetal weight fetal head position and attidude malpresentation fetal anomalies |
|
|
Term
what are the types of fetal head position and attitude 6 |
|
Definition
asynclitic brow face persistent occiput posterior; facing up, ok for vaginal mentum posterior: cannot vaginal mentum anterior: can vaginal, but difficult |
|
|
Term
3 types of fetal malpresentation |
|
Definition
comoiund: baby is trying to bring limbs out with its head (push them in) transverse lie breech |
|
|
Term
2 fetal anomalies that can cause dystocia |
|
Definition
hydrocephalus fetal tumors |
|
|
Term
5 materal conditions causing dystocia |
|
Definition
bony pelvis distended bladder colon masses axnedial masses: mass on ovary fibroids: tumors in uterine muscle, all benign |
|
|
Term
4 types of pelvis and their prognosis for delivery |
|
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 |
|
|
Term
how is dystocia categorized |
|
Definition
prolongation and arrest disorders |
|
|
Term
defne nulliparous prolonged latent phase |
|
Definition
|
|
Term
define multiparous prolonged latent phase |
|
Definition
|
|
Term
define nulliparous prolonged active phase |
|
Definition
|
|
Term
define multiparous prolonged active phase |
|
Definition
|
|
Term
how can abnormal labor be managed |
|
Definition
|
|
Term
define induction of labor |
|
Definition
stimulation of labor before the onset of contractions via pitosin |
|
|
Term
define augmentation of labor |
|
Definition
stimulation of labor contractions that are infrequent or ineffective in intensity |
|
|
Term
|
Definition
monotevifro units number of uterine contractionsin 10 min x ineensity >200 is normal labor progression |
|
|
Term
what does bishop score evaluate |
|
Definition
|
|
Term
what gets 0 points in a bishop score |
|
Definition
dilation: closed effacement: 0-30% station: -3 consistency: firm prosition: posterior |
|
|
Term
what gets 1 point in bishop score |
|
Definition
dilation: 1-2cm effacement: 40-50% station: -2, -1 consistency: medium prosition: mid |
|
|
Term
what gets 2 points in bishop score |
|
Definition
dilation: 3-4cm effacement: 60-70% station: 0 consistency: soft prosition: anterior |
|
|
Term
what gets 3 points in bishop score |
|
Definition
dilation: 5cm+ effacement: 80%+ station: 1,2 |
|
|
Term
what does a bishop score of 0-4 indicate, what tx can you do (4) |
|
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 |
|
|
Term
what does bishop score 9-13 mean |
|
Definition
induction likley successful and will have vaginal delivery |
|
|
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 |
|
|
Term
contractions to labor induction 7 |
|
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 |
|
|
Term
how can you tell a contraction in false and true labor apart |
|
Definition
pain meds take away false |
|
|
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 |
|
|
Term
true labor contractions: intervals, duration, intensity, cervix, location of pain, tx |
|
Definition
interval: regular duration: gradually increasing cervix: dilating location: back and abd tx: sedation does not relieve |
|
|
Term
false labor contractions: intervals, duration, intensity, cervix, location of pain, tx |
|
Definition
interval: irregular duration: irregular cervix: no dilation location: lower abd tx: sedation does relieve |
|
|
Term
when is prolonged second stage (active stage) too long |
|
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 |
|
|
Term
risks of prolonged labor to mom |
|
Definition
infection maternal exaustion lacerations uterine atony operative delivery: vaccum/forceps cause soft tissue injury and fetal trauma |
|
|
Term
|
Definition
uterus does not contraction to constrict vessels after birth causing hemorrhage |
|
|
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 |
|
|
Term
tx for mechnoium aspiration 3 |
|
Definition
aminofusion in utero suction catheter at birth ET suction |
|
|
Term
frequency of breech presentation |
|
Definition
2% of single pregnancies at term more frequent in premature births |
|
|
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 |
|
|
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 |
|
|
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 |
|
|
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 |
|
|
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 |
|
|
Term
how to deliver a 2000-3800 GMS |
|
Definition
|
|
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 |
|
|
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 |
|
|
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 |
|
|
Term
|
Definition
|
|
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 |
|
|
Term
|
Definition
leading edge of skull is +2 station or more |
|
|
Term
|
Definition
head is engaged but leading edge of skull is above +2 station |
|
|
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 |
|
|
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 |
|
|