The 5 P's of Labor
If the presenting part of the fetus is 1 cm below the ischial spines, the fetus is at a station of ..
+1
Birth is imminent at a station of ..
+4 - +5
Why is it important for a baby's head to be completely flexed?
Because the more flexed a baby's head, the smaller the diameter of the head that has to pass through the pelvis
What is contraction frequency?
Beginning of one contraction to beginning of another contraction
What are the three deviations from general or complete head flexion?
Military Brow Face
If the presenting part of the fetus is 1 cm above the ischial spines, the fetus is at a station of ...
-1
Do bearing down efforts have any affect on cervical dilation?
NO
What is a frank breech presentation?
Neither of the baby's legs are flexed and he is 'butt first'
If the presenting part of the fetus is even with the ischial spines, the fetus is at a station of ..
0
What do the three letters within the fetal position abbreviation stand for?
1- location of presenting part to RIGHT or LEFT of mother's pelvis 2- SPECIFIC PRESENTING PART of the fetus 3- location of presenting part in relation to the portion of maternal pelvis
What are the 5 P's of labor?
1. passenger 2. passageway 3. powers 4. position of mother 5. psychological response
The average BPD at term is what?
9.25 cm
The average suboccipitobregmatic diameter of is what?
9.5 cm
What is the 3rd letter?
A = anterior P = posterior T = transverse
If a female has a platypelloid shaped pelvis, she is more at risk for ..
A spontaneous vaginal birth
If a female has an anthropoid shaped pelvis, she will most likely have to have what type of birth?
A vaginal with forceps
What are the other three pelvic canal types a woman can have?
Android - heart shaped Anthropoid - oval shaped Platypelloid - flat shaped
What is a complete breech presentation?
Both the baby's legs are flexed
If a female has an android shaped pelvis, she will more than likely have to have a ...
C section
What is the ideal fetal presentation for a fetal delivery?
Cephalic VERTEX
What are contractions responsible for?
Effacement (shortening and thinning) and dilation (enlargement and widening) of the cervix
What makes up fetal position?
Fetal lie Fetal attitude Fetal presentation
What marks the ending of stage 1 labor?
Full cervical dilation
What is the normal fetal attitude for a successful vaginal birth?
General flexion
What is the best pelvic canal type for a vaginal birth?
Gynecoid (round)
If a baby is in a longitudinal cephalic position, it is ..
Head down
How can bearing down efforts result in fetal hypoxia and acidosis? This is known as..
If a mother holds her breath for an extended period of time while pushing Valsalva Maneuver
What is the biparietal diameter?
It is an important indicator of fetal size It is the widest part of the head entering the pelvic inlet It is the largest transverse diameter of the fetal head
What is fetal presentation?
It is the part of the fetus that enters the pelvic inlet first
What is a fetal station?
It is the relationship of the presenting part to the imaginary line drawn between maternal ischial spines
What is the suboccipitobregmatic diameter?
It is the smallest and most critical head diameter It allows the head to pass through the true pelvis easily when in complete flexion
What are advantages of an all fours laboring position?
It relieves backache if fetus is in an OP position Can assist in anterior rotation of fetus
What is the predominant laboring position used in the U.S?
Lithotomy (stirrups)
What are the two categories of fetal lie?
Longitudinal Transverse
What is the 2nd letter
O = occiput S = sacrum M = mentum Sc = scapula Sh = shoulder
What is an incomplete breech presentation?
One of the baby's legs is flexed, while the other is not
What is the Ferguson reflex?
Pressure on the cervix by the fetus that creates cervical stretching which releases oxytocin that triggers the urge to bear down
What factors relate to the passenger effect labor and birth?
Size of fetal head Fetal lie Fetal attitude Fetal presentation
What are advantages of an upright laboring position?
The advantage of gravity contractions are stronger and more efficient Labor can be shorter Improves cardiac output of mother
What is general flexion?
The baby is completely flexed from head to toe Back rounded, chin flexed on chest, thighs flexed on abdomen, legs flexed at knees, arms crossed over thorax, umbilical cord between arms & legs
What is a cephalic mentum presentation?
The baby's chin is presenting first
What is a cephalic brow presentation?
The baby's forehead is presenting first
What does fetal station measure?
The fetal descent through the birth canal
What is a cephalic presentation?
The head is the presenting part
A fetus is said to be engaged when..
The largest transverse diameter of the presenting part has passed through the maternal pelvis into the true pelvis (station 0)
What is contraction duration?
The length of the contraction
What is a cephalic vertex presentation?
The occipital region of the baby's head is presenting first (FACE DOWN)
Which fontanel, the anterior or posterior, closes up first?
The posterior The head usually resumes normal shape within 3 days
What is fetal lie?
The relation of the long axis (spine) of the fetus to the long axis of the mother.
What is fetal attitude?
The relationship of fetal body parts to each other
What is fetal position?
The relationship of presenting part to the four quadrants of the mother's pelvis
What is contraction intensity?
The strength of the contraction
What are predominant signs that precedes labor?
lightening bloody show surge of energy (nesting) Braxton hicks contractions
What are indications for labor induction with Pitocin?
bishop score of greater than or equal to 5 rupture of membranes
A bishop score of <5, membranes intact, and no regular contractions are an indication for _____
cervical ripening with prostaglandins
An increase in _______ and a decrease in _______ are thought to stimulate labor
estrogen prostaglandin
When do multiparous women experience lightening?
not until true labor is in progress
What is lightening?
the dropping and tilting forward of the uterus it usually indicates fetal engagement it usually occurs 2 wks prior to term women feel less congested but have greater urinary frequency
What is a bishop score?
the likelihood of a successful induction of labor
The higher the bishop score, _______
the more probably successful induction of labor