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Terms in this set (19)
4 P's of Labor
3. Power (Physiologic force of labor)
- Size of the maternal pelvis (diameters of the pelvic inlet, midpelvis, and outlet)
- Type of maternal pelvis
- Ability of the cervix to dilate and efface and ability of the vaginal canal and the external opening of the vagina to distend
- Fetal head size
- Fetal attitude
- Fetal lie
- Fetal presentation
- Fetal position
Power (Physiologic force of labor)
-Frequency, duration, and intensity of uterine contractions as the fetus moves through the passage
- Effectiveness of the maternal pushing effort
- Mental and physical preparation for childbirth
- Sociocultural values and beliefs
- Previous childbirth experience
- Support from significant others
- Emotional Status
When the cranial bones overlap under pressure of the powers of labor and the demands of the pelvis
Refers to the relation of the fetal body parts to one another and describes the posture the fetus assumes as it conforms to the shape of the uterine cavity; denotes whether the presenting parts of the fetus are in flexion or extension
Complete flexion, moderate flexion, partial extension, complete extension
Changes in fetal attitude, particularly the position of the head, contribute to longer, more difficult labor
Normal, most common attitude. The head is flexed so that the chin is on the chest with the arms crossed over the chest and the legs flexed at the knees with the thighs on the abdomen; ideal attitude for delivery
Military position. The neck is slightly flexed, head is straight and involves forehead presentation.
Many fetuses assume this position in early labor but convert to complete flexion as labor progresses; birth is not usually difficult
Involves brow presentation; the neck is extended and the head is moved backward. Can cause a difficult delivery due to the wide diameter of the presenting part and the opening of the pelvis
Rare and abnormal; involves face presentation and necessitates a c/s. Can result from: low amniotic fluid, fetal malformation, nuchal cord with multiple coils.
Refers to the relationship of the long axis of the fetus (spinal column) to that of the mother
A longitudinal (vertical) lie refers to a fetus that is parallel to the mother's spinal column, and a transverse (horizontal) lie refers to a fetus that is perpendicular to the mother's spinal column.
Determined by fetal lie and refers to the body part of the fetus that enters a specific section of the maternal pelvis first and leads through the birth canal during labor. Can be cephalic, breech, or shoulder.
Vertex: parietal bones or the space between the fontanels is the presenting part
Brow: head is moderately flexed causing the brow to enter first
Face: poorly flexed causing the face to present first
Mentum: hyperextension of the neck causing the chin to present first; not compatible with vaginal birth
Complete: knees and thighs of the fetus are tightly flexed, "criss-cross applesauce"; buttocks and feet present first; not compatible with a vaginal delivery
Frank: fetal hips are flexed but legs are extended and resting on the chest; pike; buttocks present first; vaginal delivery possible
Footling: fetal hips and legs are extended (single or double), feet present first; most difficult of breech deliveries but vaginal delivery is possible
Occurs when the presenting part is the shoulder, iliac crest, hand or elbow; the fetus is lying horizontally in the pelvis.
Early identification and intervention is critical, c/s is almost always necessary
Refers to the relationship of the presenting part of the fetus to the ischial spines of the mother's pelvis.
Station 0 is level with the ischial spines and when engagement occurs
Minus: presenting part is above ischial spines
Plus: presenting part is below ischial spines
[of the presenting part] occurs when the largest diameter of the presenting part reaches or passes through the pelvic inlet
Rhythmic tightening and shortening of uterine muscle from the top down; contractions ultimately result in complete cervical effacement and dilation
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