Chapter 13
The 5 Ps of Labor and Birth
Passenger, Passageway, Powers, position of the mother, psychologic response
Theory of pain based on the premise that pain sensations travel along sensory nerve pathways to the brain, but only a limited number of sensations or messages can travel through these nerve pathways at one time; by using distraction techniques (e.g., massage, music, focal points, imagery) the capacity of nerve pathways are diminished.
Gate-control theory of pain
Listening to fetal heart sounds at periodic intervals to assess fetal heart rate.
Intermittent auscultation
Deficiency of oxygen in the blood that results in abnormal FHR patterns.
Hypoxemia
“Building up” of a contraction from its onset.
Increment
Part of the feus that enters the pelvic inlet first
Presentation
Light massage (stroking) of the abdomen or other body part in rhythm with breathing during contractions.
Effleurage
Device used in external monitoring to assess fetal heart rate and pattern.
Ultrasound transducer
The interventions initiated when an abnormal FHR pattern is detected; these interventions involve providing supplemental oxygen, instituting maternal position changes, and increasing intravenous fluid administration.
Intrauterine resuscitation
The peak of a contraction.
Acme
Descent of the fetal presenting part into the true pelvis approximately 2 weeks before term for the primigravida and after uterine contractions are established and true labor is in progress for the multipara.
Lightening
Pain that pre-dominates during the first stage of labor; it results from cervical changes, distention of the lower uter-ine segment, and uterine ischemia.
Visceral
Device used in external monitoring to measure uterine activity transabdominally; it can determine the frequency, regularity, and approximate duration of uterine con-tractions but not their intensity.
Tocotransducer
Abnormally small amount of amniotic fluid.
Oligohydramnios
“Letting down” of a contraction.
Decrement
Enlargement or widening of the cervical opening (os) and the cervi-cal canal, which occurs once labor has begun; degree of progress is expressed in centimeters (cm) from less than 1 cm to 10 cm.
Dilation
Pain that pre-dominates during the second stage of labor; it results from stretching and distention of perineal tissues and the pelvic floor to allow passage of the fetus, from distention and traction on the peritoneum and uterocervical supports during contractions, and from lacerations of soft tissues.
Somatic
Device used in internal monitoring to obtain a continuous assessment of the fetal heart rate and pattern.
Spiral electrode
Instillation of room temperature isotonic fluid into the uterine cavity when the volume of amniotic fluid is low for the purpose of adding fluid around the umbilical cord and thus preventing its compression during uterine contractions or fetal movement.
Amnioinfusion
What is monitored and documented when assessing uterine contractions.
Frequency, Intensity, Duration, Resting tone
Shortening and thinning of the cervix during the first stage of labor; it is expressed as a percentage.
Effacement
Pain in labor and birth that originates in the uterus and radiates to the abdominal wall, lumbosacral area of the back, iliac crests, gluteal area, and down the thighs.
Referred
Device used in internal monitoring to measure the frequency, duration, and intensity of uterine contractions as well as uterine resting tone.
Intrauterine pressure catheter (IUPC)
Relaxation of the uterus achieved through the administration of drugs that inhibit uterine contractions.
Tocolytic therapy
An involuntary urge to push in response to the Ferguson reflex.
Bearing -down effort