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Delivery Room - Lecture

This document defines key terms related to pregnancy and labor, including gravidity, parity, gestational age, fetal presentation, and the stages of labor. It describes Leopold's maneuvers to determine fetal position and monitoring fetal heart rate. The characteristics, assessment, and stages of labor are outlined, along with the cardinal movements that occur during delivery and maneuvers to support the perineum.

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553 views3 pages

Delivery Room - Lecture

This document defines key terms related to pregnancy and labor, including gravidity, parity, gestational age, fetal presentation, and the stages of labor. It describes Leopold's maneuvers to determine fetal position and monitoring fetal heart rate. The characteristics, assessment, and stages of labor are outlined, along with the cardinal movements that occur during delivery and maneuvers to support the perineum.

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Definition of Terms:  SHOW

PREGNANCY  loosening of the mucus plug

 state of having a developing fetus in the woman’s  mucoid or bloody discharges


uterus

 starts with fertilization and ends with childbirth


Effacement
 regular duration is 38-40 weeks
thinning and shortening of the cervical canal
GRAVIDA / GRAVIDITY
Cervical Dilatation
 refers to the number of pregnancies including the
enlargement of the external cervical os to a maximum
present pregnancy regardless of the outcome and
of 10cm
duration.
 PRESENTATION part of the fetal body that engages
GRAVID
in the true pelvis and will be delivered first
 a pregnant woman
TYPES
PARITY / PARA
1. Cephalic (head)-most common presentation
 refers to the total number of pregnancies that had during delivery
reached the age of viability whether born dead or
2. Vertex - occiput
alive.
 
PRIMIGRAVIDA
 LEOPOLD'S MANEUVER
 a woman who is pregnant for the first time
- is a series of steps of abdominal palpation which is
PRIMIPARA
done to determine fetal
 a woman who has completed one pregnancy to age presentation,  position,  attitude, and  lie
of viability
Four Maneuvers
MULTIGRAVIDA
1. Fundal Palpation
 a woman who is pregnant 2x or more
to determine if it’s the fetal head or buttocks in the
MULTIPARA uterine fundus

 a woman who has completed 2 or more 2. Lateral Palpation


pregnancies to age of viability
to determine the location of the fetal back and
MULTIGRAVIDA extremities

 a woman who is pregnant 2x or more 3. Pawlick’s Grip

 MULTIPARA to determine the presenting part and if engagement has


occured
 a woman who has completed 2 or more
pregnancies to age of viability 4. Deep Pelvic Palpation

LABOR to confirm the findings of the 1st  maneuver and locate


the brow
 is a series of events by which the products of
conception are expelled from the woman's body  

 involves the 4 P's: Passage, Passenger, Power,  Monitoring the Fetal Heart Beat
Psyche
 auscultate after a contraction or during an interval
BOW in contraction
 normal range: 120-160 bpm
 bag of water / membrane that protects the fetus
 resembles the ticking of the clock
 once ruptured, woman goes into spontaneous labor
 Measuring the fundic height
within 24 hours
 from the symphysis pubis to the tip of the fundus
 Clean colorless and odorless containing of little
white specks.  
   
 Mc Donald's Method INTERVAL

Formula:  from the end of one contraction to the


beginning of the next contraction
 Months = FH in cm x 2/7
 Weeks= FH in cm x 8/7  

  INTENSITY of Contractions

AGE OF GESTATION (AOG)  The strength of uterine contraction or the degree of


tension
ADD all the days from the 1st day of the LMP (last
menstrual period) up to the present date and DIVIDE by 1. Mild - uterine wall can be indented easily; feels like
7 = AOG in Weeks the chin

o EXPECTED DATE OF CONFINEMENT / DELIVERY 2. Moderate - falls between the two ranges
(EDC or EDD)
3. Strong - uterine wall can't be indented; feels like
Naegele's Rule: Add 1 year, Subtract 3 months, and add the forehead
7 days to the first day of LMP
 
 
THE BIRTHING PROCESS
Labor Watch
Stages of Labor
Prepare the patient
1st stage - from onset of pain to full cervical dilatation
- explain the procedure
- Latent (0-3cm) - mild labor
- provide privacy
- Active (4-7cm) - active labor
- place in side-lying position
- Transition (8-10cm) - peak of labor
 Place fingertips on the uterine fundus and palpate
2nd stage - from full dilatation to delivery of the baby
lightly
3rd stage - from delivery to placental expulsion
 Three Phases of a Contraction
4th stage - delivery of placenta to post partum
1. Increment - "building up"
stabilization
2. Acme - peak
Ritgen's maneuver-maneuver use to support the
3. Decrement - “letting down" perineum during delivery of the fetal head.

 Assessment of Labor Brant Andrew's maneuver-this is the maneuver use in


Controlled traction and counter traction.A technique for
FREQUENCY expressing the placenta from the uterus during the 3rd
 refers to the time between the beginning of one stage of labor.
contraction and the beginning of the next Positioning during LABOR:
 DURATION

 beginning of one contraction to the end of the


same contraction

CHARACTERISTICS OF UTERINE CONTRACTIONS

DURATION

 Latent (cervix 0-3cm)

= 15-30 secs

 Active (cervix 4-7cm)

= 30-45 secs
 
 Transition (cervix 8-10cm)

= 45-90 secs
Mechanisms of Labor/Cardinal Movements of Labor

1. Engagement-Presenting part is at the level of


ischial spine..this is the largest diameter of the
fetal head has entered the pelvis.
2. Descent-Downward movement of the biparietal
diameter of the fetal head within the pelvic
inlet.
3. Flexion-moves further downward and then the
fetal head meets obstruction at the pelvic floor
causing flexion.
4. Internal Rotation-Head rotates 45 degrees
5. Extension-Head of the baby extends as the fetal
head passes beneath the symphysis pubis
6. External rotation-Fetal head rotates back into
the diagonal or transverse position to deliver
the shoulders
7. Expulsion-Once the shoulder is delivered the
rest of the body is delivered easily and
smoothly.

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