Labor Complications
define dystocia
Long, difficult, or abnormal labor caused by problems with powers, passenger, passage, or psyche.
what is the purpose of the Bishop score
To evaluate cervical readiness for induction.
define shoulder dystocia
Fetal head delivers, but shoulders fail to deliver due to impaction.
one maternal indication for C/S delivery
CPD, placenta previa, malpresentation, previous classical C/S, or maternal medical condition.
define PTL
Uterine contractions with cervical change occurring between 20–37 weeks.
difference between hypertonic and hypotonic contractions
Hypertonic: poor quality, increased resting tone, latent phase.
Hypotonic: weak, insufficient contractions, active phase.
one indication and one contraindication for labor induction
Indication: post-term pregnancy. Contraindication: placenta previa.
name two interventions for shoulder dystocia
McRoberts maneuver, suprapubic pressure, repositioning, prepare for C/S.
one risk for mother and one for baby with C/S delivery
Mom: hemorrhage, infection, injury.
Baby: respiratory distress, surgical injury.
two risk factors for PTL
Previous preterm birth, infection, smoking, multiple gestation, poor prenatal care, low weight.
risks to mom and baby with hypotonic labor
Mom: exhaustion, infection, hemorrhage. Baby: poor oxygenation, sepsis, prolonged pressure on head.
name two methods of cervical ripening
Mechanical dilators, prostaglandins (Cervidil, Cytotec), membrane stripping, or balloon catheter.
s/s of uterine rupture
Sudden fetal distress, abnormal FHR, sharp abdominal pain, loss of station, shock.
contraindication to VBAC
Previous classical uterine incision or uterine rupture.
medications to stop PTL
Terbutaline, nifedipine, indomethacin, magnesium sulfate.
what is cephalopelvic disproportion (CPD)
When the fetal head is too large to fit through the maternal pelvis.
what is an amniotomy and the #1 nursing intervention after
Artificial rupture of membranes; monitor FHR for cord prolapse or decelerations.
what is cord prolapse and one nursing intervention
Umbilical cord slips below presenting part. Intervention: relieve pressure with hand, position mom (knee-chest/Trendelenburg), prepare for C/S.
primary risk associated with TOLAC
Uterine rupture.
risks for mom and baby with post-term pregnancy
Mom: perineal trauma, hemorrhage, operative delivery.
Baby: macrosomia, aging placenta, meconium aspiration, IUFD.
how can maternal psyche contribute to dysfunctional labor
Fear and anxiety release stress hormones that interfere with contractility and decrease placental perfusion.
define external cephalic version and list one contraindication
Manual turning of fetus to cephalic position after 37 weeks.
Contraindication: multiple gestation, uterine anomalies, or previous uterine rupture.
symptoms of amniotic fluid embolism
Sudden hypoxia, hypotension, chest pain, dyspnea, frothy sputum, coagulopathy, cardiac arrest.
nursing responsibilities when managing a VBAC patient
Obtain consent, continuous monitoring, IV access, monitor for rupture signs.
interventions when managing post-term labor
Kick counts, NSTs, BPP, induction, amniotomy, oxytocin, monitor for dystocia.