Module 5: Stages of Labor (Part 1)

18-20 hours

What is the overall average time of delivery for primiparous women?

12-14 hours

What is the overall average time of delivery for multiparous women?

First Stage (Dilatation)

This stage of labor starts with the initiation of true labor contractions and ends with the cervix fully dilated (10cm) and complete effacement.

Latent, Active, and Transitional Phase

What are the three phases of the first stage of labor?

False

True or False: When the client is in pain during the latent phase, analgesia is given as a reliever.

Latent Phase

This phase involves mild and short uterine contractions that last 20-40 seconds long, occur 10-20 minutes apart, and end with the cervix dilated at 3cm.

Active Phase

This phase involves stronger and longer uterine contractions that last 40-60 seconds long, occur 3-5 minutes apart, and end with the cervix dilated at 4-7cm.

Transitional Phase

This phase involves uterine contractions at their peak intensity that last 60-70 seconds long, occur 2-3 minutes apart, and end with the cervix fully dilated and effaced at 8-10cm.

Hyperventilation

This is brought about by deep exhalation and may lead to respiratory alkalosis, which is characterized by lightheadedness, numbness at the toes and fingertips, and loss of consciousness.

True

True or False: Taking the FHT once the uterus is contracted as it is prone to display unreliable results.

2-3 hours

The bladder must be emptied every __ as a distended bladder may retard fetal descent or cause urinary stasis.

Bearing down

This is only done during true labor contractions to minimize maternal exhaustion, prevent lacerations, and aid in fetal descent.

Sim’s position

Which position favors the anterior rotation of the head allowing for faster delivery, promoting relaxation between contractions, and preventing supine hypotension syndrome?

hour, 30 minutes

Blood pressure and fetal heart rate must be taken every __ during the latent phase and every __ during the active phase.

Demerol

This is usually given to suppress the sensory portion of the cerebral cortex, therefore reducing pain during labor.

7-8 cm

The cervix must be dilated at how many centimeters before transfer to the delivery from the labor room?

Full descent

This occurs when the fetal head protrudes beyond the dilated cervix and touches the posterior vaginal floor.

Descent, Flexion, Internal Rotation, Extension, External Rotation (Restitution), and Expulsion

Based on the acronym DFIERE, what are the cardinal movements of labor?

Acceleration

This refers to a short-term rise in the heart rate of at least 15 bpm, lasting at least 15 seconds, which is normal and healthy.

Fetal movement, change in maternal position, or analgesics

What are the causes of accelerations in fetal heart rate?

True

True or False: Early decelerations are generally normal and not concerning.

Fetal head compression

Early decelerations are caused by?

Tocodynamometer

It refers to a pressure-sensitive device that increases myometrial tension and is measured through the abdominal wall.

Cephalopelvic disproportion

In instances where early deceleration is detected in early labor, the mother may have __.

Late deceleration

This refers to a 30-40-second delay after the onset of contractions and continues beyond the end of contraction.

Uteroplacental insufficiency

Late decelerations are caused by?

Prolonged deceleration

This refers to a decrease in FHR of 15 bpm or more and lasts longer than 2-3 minutes.

Cord compression or maternal hypotension

Prolonged deceleration may be caused by?

A

Which of the following equipment is not needed during the delivery for multiparous women?

A. Tissue forceps

B. Sanitex/sterile towel

C. Cord clamp

D. Bandage scissor

Median episiotomy

This type of episiotomy begins in the midline of the perineum and is directed toward the perineum to facilitate a smaller cut with less blood loss.

Mediolateral episiotomy

This type of episiotomy begins in the midline of the perineum but is directed laterally away from the rectum.

False

True or False: Once crowning occurs, a woman is asked to push more to aid in the expulsion of the fetus.

50-100mL

How many mL of blood is flowing from the placenta to the newborn during delayed cord clamping?

Second stage

This stage spans from the time of full dilation and effacement to the birth of the infant.

Schultz presentation

The placenta separates first at its center, with the fetal surface evident, therefore making it shiny. This presentation is called?

Duncan presentation

The placenta separates first at its edges, with the maternal surface evident, therefore making it dirty. This presentation is called?