Please be familiar with each term prior to the first day of class Be prepared to submit on first day of clinicals
and be tested on at end of clinicals
1. Definition- the period before childbirth
2. Reasons for Admission
Preterm Labor- uterine contractions causing cervical change that occur between 20-37 weeks of pregnancy. Premature Rupture of Membranes- the spontaneous rupture of the amniotic sac and leakage of amniotic fluid that occurs at any time before labor. Women report a sudden gush or slow leak of fluid from the vagina. Women are hospitalized in order to prolong pregnancy to allow the fetus to mature unless complications such as infection occur. Gestational Diabetes Mellitus- glucose intolerance that occurs during pregnancy. Poor control of blood glucose levels during pregnancy can increase the risk for miscarriage. Twin Gestational- circulatory problems can occur if the umbilical cords tangle impeding circulation causing one or both fetus to die. Hyperemesis- excessive vomiting that occurs during pregnancy that causes weight loss, electrolyte imbalance, nutritional deficiencies, ketonuria; it may be due to high levels of estrogen and hCG; can lead to lack of nutrition for fetus causing low weight and premature birth. Hypertension (Preeclampsia)- development of hypertension and proteinuria after 20 weeks of pregnancy in a women who usually has normal blood pressure. Incompetent Cervix- cervix that is unable to remain closed until a pregnancy reaches term because of a mechanical defect in the cervix resulting in dilation and effacement during the 1st and 2nd semester. Thyroid- hormone secretion increases during pregnancy due to increased estrogen levels, thyroid activity increases causing an enlargement of thyroid gland. Although hyperthyriodism is rare it can occur during pregnancy. Placenta Previa- placenta is implanted in the thin lower uterine segment such that is completely or partially covers the cervix or is close enough to the cervix to cause bleeding when the cervix dilates or the lower uterine segment effaced. HIV- Transmission of HIV from maternal to fetus can occur at any time throughout the perinatal period through maternal circulation or through breast milk to infant. LABOR AND DELIVERY
1. Stages of Labor
Stage 1: Begins with onset of regular uterine contractions and ends in full cervical effacement and dilation. latent phase (3cm), active phase (4-7cm) , transition phase (8-10cm of dilation) Stage 2: the birth of the baby. Begins with full cervical dilation (10 cm) and complete effacement and ends in baby’s birth. Stage 3: the birth of the baby until the placenta is expelled. The placenta usually takes about 10-15 minutes to be expelled. Stage 4: Initial period of recovery from birth. (1-2 hrs after birth) 2. Fetal and Uterine Monitoring: Interpreting strip – Electronic fetal monitoring is a way to continually assess fetal oxygenation. The fetal heart rate (FHR) tracings are analyzed for both the occurrence of hypoxia and metabolic acidosis. This can be done by either external or internal monitoring during labor. External monitoring for consist of the use of transducers placed on the mothers abdomen to assess FHR and uterine activity. An ultrasound transducer is used to monitor FHR by reflecting high frequency sound waves from the movements of fetal heart and balances. A tocotransducer is used to measure uterine activity by placement over the fundus of the umbilicus in order to measure the frequency and duration of uterine contractions. Internal monitoring of the FHR is done by use of a spiral electrode that converts the fetal ECG from the presenting part to the FHR via a cardiotachometer. An intrauterine pressure catheter (IUPC) monitors the frequency, duration, and intensity of uterine contractions. The pressure obtained on the catheter strip is converted into millimeter of mercury on the uterine activity panel of the strip chart. 3. True Labor and False...
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