1
Engagement is station zero and this means
Presenting part is at the ischial spines
If baby stays at -3, -2,-1 it can't get through
vaginally, it needs a c section for delivery
A pregnant woman comes in to L&D (labor and delivery). She is 5 cm dilated, with contraction 5
minutes apart, lasting 45 seconds. What phase of labor is the pt in?
• The pt is in ACTIVE phase
What is the #1 priority of second phase?
What is the #1 priority of second stage?
What is the #1 priority of third phase?
What is the #1 priority of third stage?
What is the #1 priority of second phase?
• Pain management
What is the #1 priority of second stage?
• Clearing baby’s airway
Questions
What is the #1 priority of third phase?
• Checking cervical dilation, Helping pregnant mother with breathing and pain management
What is the #1 priority of third stage?
• Assess the placenta for smoothness and intactness, and for 3-vessel (not 2) umbilical cord
present
Intensity of labor is purely_____
Subjective: teach her how to palpate with one hand over the fundus with pads of the fingers
Hormone that increase levels making the uterus more sensitive to oxytocin
Estrogen
Most common presentation and which to pick first
ROA or LOA
Pick ROA befor LOA
One good studying strategy to use for memorizing the 3 phases of Stage 1 labor is to know
everything about the Active (or Phase 2) of Stage 1
• Once you know the upper and lower limit values,
you can deduce the values of Phase 1 and
Phase 3
Uterine contraction should be no longer than-------and no closer than-
-------
Uterine contraction should be no longer than 90 seconds and no closer than 2 minutes
Complications of labor
How many complications
How many protcols
18 complications
3 protocols
Hormone that signals the uterus to contract: also known as the love hormone as it plays a role in bonding and is released during sexual activity
oxytocin
Lie is relationship between the spine of the mother and spine of the baby. You want a
Vertical lie compatible with vaginal birth.
If mother's spine and babys spine is parallel we got a baby
Stages and Phases of Labor
• Stage 1—Onset of
o Phase 1—
o Phase 2—
o Phase 3—
• Stage 2—Delivery of
• Stage 3—Delivery of
Stage 4- recovery 2
• Stage 1—Onset of Labor ! Cervical Dilation and Effacement
o Phase 1—Latent
o Phase 2—Active
o Phase 3—Transition
• Stage 2—Delivery of Baby
• Stage 3—Delivery of Placenta
stage 4 recovery 2 hours until bleeding stops
What is a sign of uterine tetany?
What parameters regarding uterine contraction would make you stop Pitocin?
What is uterine hyperstimulation?
What is a sign of uterine tetany?
• No longer than 90 seconds and no closer than 2 minutes
What parameters regarding uterine contraction would make you stop Pitocin?
• No longer than 90 seconds and no closer than 2 minutes
What is uterine hyperstimulation?
• No longer than 90 seconds and no closer than 2 minutes
OP anything
right or left occiput posterior
Hormone that causes the cervix to soften or ripen allowing to stretch open
prostaglandins
If lie is perpendicular-transverse lie we have
Trouble- c section
What is purpose of uterine contraction in first stage?
What is the purpose in 2nd stage?
What is the purpose 3rd stage?
What is the purpose of 4th stage?
When does postpartum technically begin?
What is purpose of uterine contraction in first stage?
• Dilation and effacement of the cervix
What is the purpose in 2nd stage?
• Delivery of baby
What is the purpose 3rd stage?
• Delivery of placenta
What is the purpose of 4th stage?
• Stop bleeding
When does postpartum technically begin?
• 2 hours after delivery of placenta
Assessment of freq of contraction. Freq is from the
beginning of one contraction and beginning of the next
Painful back pain_"OP"-Ohpain. what do you do?
Knee to chest position then push with fist into sacrum to counter pressure
Hormone that relaxes the cervix ligaments and connective tissues and allows greater flexibility of joints, allowing baby to move easily pass through pelivis
relaxin
Stage 1 one set labor has how many phases, names of phases, dilation, contractions times and intensity
3 phases
Latent—cervical dilation from 0 to 4 cm
o Phase 1
o Contractions are 5 to 30 minutes apart, lasting 15 to 30 seconds
o Mild intensity
• Active—cervical dilation from 5 to 7 cm
o Phase 2
o Contractions are 3 to 5 minutes apart, lasting 30 to 60 seconds
o Moderate intensity
• Transition—cervical dilation from 8 to 10 cm
o Phase 3
o Contractions are 2 to 3 minutes apart, lasting 60 to 90 seconds
o Strong intensity
Pay attention to whether the question is asking about stages or phases
• There are
• There are 3 phases, which are part
Pay attention to whether the question is asking about stages or phases
• There are 4 stages
• There are 3 phases, which are part of Stage 1
Assessment of duration of contraction is duration of contraction is from the beginning
to the end of one contraction
Prolapsed cord steps
push headin off cord and position knee chest or trendelenburg
prep for c section
think push/position
(push head off the cord of fetus and position mother to knee chest)