Documente Academic
Documente Profesional
Documente Cultură
Prostaglandins,
formed
by
the
uterine deciduas under level of
concentration in the amniotic fluid
and blood of women increases
during labor. Research has shown
prostaglandin to be very effective in
inducing uterine contraction at any
stage of gestation. Initiation of labor
is said to be the result of the release
of arachidonic acid is believed to
increase prostaglandin synthesis
contractions.
5. Theory of Aging Placenta as the
placenta matures, blood supply
decreases
resulting
in
uterine
contractions.
Related Terms:
Labor is the process of moving the
fetus, placenta and membranes out of
the uterus and through the birth
canal. Synonymous with childbirth and
parturition.
Delivery is the actual birth of baby
Crowning encircling of the largest
diameter of the babys head by the
vulvar ring
Effacement shortening and thinning
of the cervical canal. It is expressed in
percentage (%).
Dilatation is the enlargement of the
cervical os from an orifice a few
millimeters in size to an aperture large
enough to permit the passage of the
fetus.
Show is a mucoid discharge from the
cervix that is present after the
mucous plug has been discharged.
Attitude the relationship of the fetal
parts to one another
painless
irregular
contractions,
sometimes strong that may cause
discomfort
4. Ripening of the cervix Goodells
sign: the cervix feels softer than
normal
similar
to
earlobe
throughout pregnancy; at term
cervix is described butter-soft
Signs of TRUE LABOR:
1. Uterine Contractions surest sign
that labor has begun
Origins
Labor contractions begin a
pacemaker point located in the
myometrium near one of the
uterotubal junctions
In some women, contractions
appear to originate in the lower
uterine segment rather than in the
fundus.
Phases
3 Phases: increment, acme,
decrement
Increment- when the intensity of
the contraction increases
Acme- when the contraction is at
its strongest
Decrement- when the intensity
decreases
As labor progresses the relaxation
intervals decrease from 10 minutes
to 2 3 minutes
The duration also changes from 2030 sec to a range of 60-90 sec
Contour Changes
Upper segment becomes thicker
and active, preparing it to be able
to exert the strength necessary to
expel the fetus when the expulsion
phase of labor is reached
The lower segment becomes thinwalled, supple, and passive so that
the fetus can be pushed out of the
uterus easily
Physiologic retraction ring a ridge
on the inner uterine surface that
marks the boundary between the 2
portions
Pathologic retraction ring (Bandls
ring) it is a danger sign that
signifies impending rupture of the
lower uterine segment if the
obstruction to labor is not relieved
Cervical Changes
Effacement
Nursing Care:
- Finds assessment
techniques between
contractions
- Assists with frequent
position change
- Applies counter pressure to
sacrococcygeal area
- Encourages and praises
- Keeps woman aware of
progress
- Check bladder and
encourages voiding
- Gives oral care
Transition Phase
Contractions reached their peak
of intensity occurring every 2-3
minutes with duration of 6090sec
Maximum dilatation 8-10cm
Complete cervical effacement
Woman experiences intense
discomfort accompanied by
nausea and vomiting
Woman may also experience a
feeling of loss of control,
anxiety, panic or irritability
2. Stage 2 (Stage of Expulsion) the
period from full dilatation to birth of the
infant
1. External transabdominal,
noninvasive, monitors uterine contraction
and FHR; client needs to decrease extraabdominal movements
2. Internal membranes must be
ruptured, cervix sufficiently dilated and
presenting part; invasive procedure;
continuous monitoring
- results of monitoring: normal FHR
120-160; must obtain a baseline
Acceleration 15 bpm rise above
baseline followed by return; usually in
response to fetal movement or
contractions; indicates fetal well-being
Deceleration fall below baseline lasting
15 seconds or more, followed by a return:
a. Early Deceleration are periodic
decreases in the FHR resulting from
pressure on the fetal head during
contraction (head compression)
b. Late Deceleration indicative of
fetal hypoxia because of deficient
placental perfusion (uteroplacental
insufficiency)
c. Variable Deceleration occurs at
unpredictable times during contractions
and indicates cord compression
Anesthesia encompasses analgesia
amnesia, relaxation and reflex activity. It
abolishes pain perception by interrupting
the nerve impulses to the brain. The loss
of sensation may be partial incomplete,
sometimes with loss of consciousness.
Analgesia refers to the alleviation of the
sensation of pain or in the raising of the
threshold for pain perception without loss
of consciousness