OB and Peds Notes
* Getting Ready Signs of Labor: happens 2-3 weeks prior to true labor ~ lightening (engagement): baby drops down and presses on bladder ~nesting: mom has sudden burst of energy ~Braxton Hicks contractions ~cervical ripening (softening and dilating) ~bloody show * Effacement: the thinning of the cervix; measured from 0-100%
* Dilatation: the opening of the cervix; measured from 0-10 cm
* Stages of Labor: ~1st Stage -Early/Latent: -0-3 cm dilatation -contractions 5-30 min apart -lasting 30-45 seconds -mild to moderate intensity -lasting 6-8 hours -Active: -4-7 cm dilatation -contractions 3-5 min apart -lasting 40-70 seconds -mild to strong intensity -lasting 3-6 hours -inwardly directed, focused, serious -Transition: -8-10 cm dilatation -contractions 2-3 min apart -strong intensity -lasting 45-90 seconds -lasting about 20-30 min -severe pain, N/V, irritable ~2nd Stage: Pushing -from complete dilatation until the birth of the baby -Early/Latent: -contractions are weak; no urge to push yet -Active: -strong contractions resume; urge to push comes (Ferguson reflex) ~3rd Stage: Placenta -from the delivery of the baby to the delivery of the placenta -usually occurs within 10 min -uterus changes shape; globular right before it detaches; sudden gush of blood; cord lengthens ~4th Stage: Post partum Recovery -1st hour after birth -Post partum period: 1st 6 weeks
*Cardinal Movements: ~Descent: head enters the pelvis ~Flexion: occurs as head meets resistance ~Internal Rotation: head rotates L to R ~Extension: head extension as it goes under the symphysis pubis ~Restitution: shoulders enter pelvis and head rotates; neck twists then untwists and head aligns with back ~External Rotation: shoulder rotates; head is turned farther to 1 side ~Expulsion: anterior shoulder moves under symphysis and is delivered; then
* Dilatation: the opening of the cervix; measured from 0-10 cm
* Stages of Labor: ~1st Stage -Early/Latent: -0-3 cm dilatation -contractions 5-30 min apart -lasting 30-45 seconds -mild to moderate intensity -lasting 6-8 hours -Active: -4-7 cm dilatation -contractions 3-5 min apart -lasting 40-70 seconds -mild to strong intensity -lasting 3-6 hours -inwardly directed, focused, serious -Transition: -8-10 cm dilatation -contractions 2-3 min apart -strong intensity -lasting 45-90 seconds -lasting about 20-30 min -severe pain, N/V, irritable ~2nd Stage: Pushing -from complete dilatation until the birth of the baby -Early/Latent: -contractions are weak; no urge to push yet -Active: -strong contractions resume; urge to push comes (Ferguson reflex) ~3rd Stage: Placenta -from the delivery of the baby to the delivery of the placenta -usually occurs within 10 min -uterus changes shape; globular right before it detaches; sudden gush of blood; cord lengthens ~4th Stage: Post partum Recovery -1st hour after birth -Post partum period: 1st 6 weeks
*Cardinal Movements: ~Descent: head enters the pelvis ~Flexion: occurs as head meets resistance ~Internal Rotation: head rotates L to R ~Extension: head extension as it goes under the symphysis pubis ~Restitution: shoulders enter pelvis and head rotates; neck twists then untwists and head aligns with back ~External Rotation: shoulder rotates; head is turned farther to 1 side ~Expulsion: anterior shoulder moves under symphysis and is delivered; then