| A | B |
|---|
| Effacement | A %; 100% = thin, slick membrane over fetus; estimated by touch |
| Dilation | In cm; full = 10; estimated by touch |
| Increment | Phase of uterine contractions; increasing strength |
| Acme | Phase of uterine contractions; peak; greatest strength |
| Decrement | Phase of uterine contractions; decreasing strength |
| Frequency | Elapsed time from beginning of one contraction until the beginning of the next contraction; minutes |
| Duration | Elapsed time from the beginning of a contraction until the end of the same contraction; seconds |
| Intensity | Mild, moderate and strong; approximate strength of contraction |
| Mild Intensity | Uterus easily indented with the fingertip (tip of nose) |
| Moderate Intensity | Uterus can be indented with > difficulty (chin) |
| Strong Intensity | Uterus is not easily indented (forehead) |
| Interval | Amt of time uterus relaxes btwn contractions; placenta refills with oxy blood for fetus; fetal waste removed |
| Anterior fontanel | Diamond shaped; formed by intersection of four sutures; closes 12-18 months |
| Posterior fontanel | Triangular depression; formed by intersection of three sutures; closes by end of 2nd month |
| Lie | How the fetus is oriented to the mother's spine |
| Longitudinal lie | 99% of births; fetus parallel to mom's spine |
| Transverse lie | Right angles to the mom's spine; AKA shoulder presentation |
| Oblique lie | Fetus is btwn longitudinal and transverse lie; diagonal |
| Attitude | Degree of flexion |
| Presentation | Refers to fetal part that enters the pelvis first |
| Cephalic presentation | 96% of births; head first |
| Vertex presentation | Cephalic; fetal chin flexed on chest complete flexion |
| Military presentation | Cephalic; moderate flexion; looking forward "at attention" |
| Brow presentation | Cephalic; poor flexion (extension); slightly looking up |
| Face presentation | Cephalic; Full extension; looking where they are going; face first |
| Frank breech presentation | Fetal legs flexed at the hips and extended toward shoulder |
| Full (complete breech) presentation | Breech; legs flexed, knees flexed (cross legged) |
| Single footling breech presentation | Sticks a toe out first |
| Position | Refers to reference point on fetal presenting part oriented w/in the mom's pelvis |
| Occiput position | Refers to the orentation if the fetus is in a cephalic vertex presentation |
| Sacrum position | Describes fetus in a breech presentation |
| Shoulder and back position | Refers to shoulder presentation (transverse lie) |
| Station | Relationship of fetal presenting part to an imaginary line between the ischial spines |
| Braxton-Hicks contractions | Aids in cervical ripening; sign of impending labor |
| Increased vaginal secretions | Clear and non-irritating; signs of impending labor |
| Bloody Show | Cervix softens, effaces, dilates causing loss of mucous plug which tear capillaries; sign of impending labor |
| Energy spurt | Sudden burst of energy; sign of impending labor |
| Weight loss | Hormonal changes prior to delivery, excretes extra body water; sign of impending labor |
| Lightening | Baby drops; engages; sign of impending labor |
| True labor | Indicated by progress (cervical change) |
| Desent | Station describes the level of presenting part in pelvis; measured from ischial spine |
| Engagement | Fetus is at 0 station; prior to labor in nullipara, later in mulipara |
| Flexion | Fetal head flexion increases with uterine contraction until chin is on chest |
| Internal rotation | Fetus enters pelvis, moves down, head turns occiput directly under symphysis pubis (OA) |
| Extension | Fetal head changes from flexion to extension to negotiate curve, neck stops under symp. pubis and swings ant. and extends with each push |
| External rotation | Head born, turns to one side, realigns with shoulders, face mom's thigh, shoulders turn w/in pelvis |
| Expulsion | Anterior shoulder, then posterior shoulder are born quickly followed by rest of body |
| Fetal hear rate variability | Fluctuation, or constant changes in the baseline |
| Fetal heart rate periodic changes | Temporary changes in baseline rate |
| Fetal heart rate accelerations | Rate > 15 beats faster/lasting for 15 senconds |
| Fedal heart rate early decelerations | Rate decreases during contraction |
| Fetal heart rate variable decelerations | Begin and end abruptly, inconsistent pattern |
| Fetal heart rate late deceleration | Returns to baseline when contraction ends |
| Pain Threshold | Pain perception, remains a constant |
| Pain tolerance | amt of pain one is willing to endure, can change under different conditions |
| Childbirth and pain: cervical readiness | If not ripe may increase contraction and incease pain |
| Childbirth and pain: pelvis | Abnormalities lengthen labor and increase maternal fatigue |
| Childbirth and pain: labor intensity | Rapid changes in intensity may increase perception of pain |
| Childbirth and pain: fatigue | Decreases pain tolerance |
| Effeurage stimulation | Firm pressure, circular movements to abd, stim of large-diameter serve fibers that inhibit paintul stimuli |
| Sacral pressure | firm pressure against lower back helps relieve some of the back pain |
| Thermal stimulation | prn cool clothes versus warm blankets, etc |
| Mental stimulation: focal point | internal or external picture, object, or spot to focus on during contraction concentration |
| Mental stimulation: imagery | Creation of a tranquil mental image for relaxation and peace |
| AROM | Artificial rupture of membranes; technique amnihook |
| Induction | Initiation of labor before it begins naturally |
| Augmentation | Stimulation of contractions after they have begun naturally |
| Indications | If risk is > for woman and fetus if pregnancy continues |
| Laminaria | Narrow cone inserted into cervix, absorbs water, swells, causes beginning of cervical dilation |
| 1st and 2nd degree episiotomy/laceration | Uncomplicated, do not affect rectal sphincter |
| 3rd degree episiotomy/laceration | Extends into the rectal sphincter |
| 4th degree episiotomy/laceration | Extends completely through the rectal sphincter |
| Chignon | Circular edema to the scalp |
| Hypotonic labor dysfunction | Contractions too weak to be effective; Contractions decrease after active labor (4 cm) |
| Hypertonic labor dysfunction | Contractions are frequent, cramp like, and poorly coordinated; painful, nonproductive during latent phase (before 4cm) |
| PROM | at term 38+ weeks before labor contractions |
| PPROM | Before term < 38 weeks; with or without contractions |
| Preterm Labor | 20-38 weeks of gestation; immaturity of newborn |
| Prolonged pregnancy | > 42 weeks; postterm |
| Prolapsed umbilical cord | Slips downward in pelvis after ROM causing compressio and decreased oxy to fetus |
| Uterine rupture | Tear in the uterine wall occurs if the muscle cannot withstand the pressure inside the organ |
| Complete uterine rupture | Hole through the entire uterus, from uterine cavity to abd cavity |
| Incomplete uterine rupture | Uterus tears into nerby structure, but not into abd (ex. ligament) |
| Dehiscence uterine rupture | Old uterine scar, usually from previous C/C birth |
| Uterine inversion | Uterus turn inside out after birth; rapid onset of shock; hyst may be necessary |
| Amniotic fluid embolism | Fluid et particles enter the woman's circulation and obstucts small blood vessels in her lung |
| Lochia rubra | Red; lasts for 3 days after birth |
| Lochia serosa | Pinkish (blood + mucus); 3rd through 10th day after birth |
| Lochia alba | White to clear (mucus); 10th-21st day after birth |
| Scant lochia | Less than 1 inch |
| Light lochia | Less than 4 inches |
| Moderate lochia | Less than 6 inches |
| Heavy lochia | saturated pad |
| Excessive lochia | Saturated pad in 15 minutes |
| Afterpain | Painful intermittent uterine contractions greater with breast feeding |
