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ANW 8056 Module 1
Terms in this set (10)
Name all the bones of the maternal pelvis. Briefly describe their function and any important landmarks that might be associated with them.
- Two innominate bones (3 parts: ilium - posterior upper portion; ischium - medial and lower portion; pubis- anterior portion)
- Important landmarks: ischial spine, ischial tuberosity, pelvic sidewall, and pubic arch
- Sacrum - posterior portion of the pelvis
- Coccyx - posterior portion of the pelvis
Describe the true and false pelvis.
False Pelvis: iliac fossa and iliac crest - has little obstetrical significance, it's the lower abdominal cavity border.
True Pelvis: has obstetrical significance because the fetus must navigate through these areas.
The planes of the pelvis are what? Which is the smallest diameter that the baby must pass through?
Has 3 planes of obstetrical significance: Pelvic inlet, midplane, and outlet. In the pelvic midplane, the transverse diameter (interspinous diameter) is the smallest diameter of the pelvis that the fetus must go through (typically 10cm)
What muscles are typically involved in a second degree laceration?
Bulbocavernosus muscle and the transverse perineal muscle
Describe the first stage of labor
The first stage of labor begins with true labor contractions, as evidenced by progressive cervical change, and ends when the cervix is completely dilated (approximated at 10 centimeters) and ready for passage of the fetal presenting part. It is known as the stage of cervical dilatation.
Latent Phase of Labor
Beginning of regular uterine contractions to the point when cervical dilation begins to progress rapidly.
Uterine contractions become established during the latent phase as they increase in frequency, duration, and intensity.
Active Phase of Labor
Starts with an increase in the rate of cervical dilation (the end of the latent phase of labor) and ends with complete cervical dilation (the beginning of the second stage of labor).
Progressive descent of the fetal presenting part also typically occurs during the latter part of the active phase and in the second stage of labor.
What are the cardinal movements of labor? (Know these in order!!)
4. Internal rotation
Birth of head
7. External rotation
8. Lateral flexion or expulsion
Birth of shoulders
Discuss membrane sweeping
- This process releases prostaglandins, which aid in the preparation and initiation of labor. Numerous studies have demonstrated that membrane sweeping increases the likelihood of spontaneous labor
-Evidence shows a reduced rate of pregnancy continuing beyond 41 weeks when membrane sweeping is done, with no increase in adverse outcomes. Evidence has also found membrane sweeping to be safe with no increased risk of fetal or maternal infection.
- The technique for performing membrane sweeping is as follows: The examining fingers of the practitioner's sterile gloved hand are introduced into the vagina, enter the cervical os, and swing circumferentially around the internal os, separating the membranes from the uterine wall. If the cervical os is closed and membrane sweeping cannot be performed, some clinicians recommend massage of the cervix at the vaginal fornices, as this intervention may cause release of prostaglandins. Membrane sweeping can be repeated in 36 to 48 hours.
Note the diameters of the pelvis in length
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