Exam 2 Study Guide 1
1) Physiological effects of the birth process: The most obvious changes in pregnancy and birth are
the woman’s reproductive
... [Show More] system, also the cardiovascular, respiratory, GI, urinary and hematological.
• Frequency: the beginning of one contraction to the beginning of the next.
• Duration: Beginning of one contraction to the end of the same one.
• Intensity: The strength of a contraction
• Resting: Time between one contraction to the next
Contraction cycle:
• Increment: the period of increasing strength.
• Acme: the period during which the contraction is most intense
• Decrement: period of decreasing intensity as the uterus relaxes.
• Interval: end of one contraction to the beginning of the next.
MOTHER
Cervical changes: In the uterus the upper 2/3 thickens and pushes down on to the bottom of the
uterus (like an upside down egg), the bottom of the uterus is thin to create a reduced resistance with
the contractions and allow dilation and effacement to occur in the cervix. In primimother effacement
occur before dilation. In Multi it occurs at the same time
• Effacement is the thinning and shortening of cervix (in percent %). The cervix becomes
thinnger and shorter as the fetus and amniotic sac is drawn over it.
• Dilation is the opening of the cervix (expressed in cm), as the pressure of the fetus opens it.
• Station is the point where the baby is headed as to the ischeal spine (-2 -1 0 1 2 3)
Cardiovascular: With each contraction there is a 300-500mL shunt of blood into the maternal
circulation causing an increase in blood volume for the mother, slowing her HR. Avoid supine
position to prevent hypotension and position to increase blood return.
Respiratory: During labor the mother is anxious, fatigue and exhausted so her RR is increased.
This decrease pH and may cause Resp Alkalosis, so promote slow breathing or into a paper
bag.
GI: Slow motility can result in nausea and vomiting, also dry mouth. Ice chips may be used. Solid
foods are not used to prevent aspiration incase general anesthesia needs to be used.
Urinary system: Reduced sensation of full bladder. May be due to regional anesthesia or the
contractions. Mother will not notice, and will create a discomfort, and occupies more space in
the pelvis.
Hematopoietic: About 500mL of blood is lost through vaginal delivery. Important to look at labs
( WBC, PLT) and also clotting factors to protect from hemorrhage and DVT.
FETAL RESPONSE
Placenta: During strong labor contractions, the blood supple decreases, so exchange occurs
between contractions. The baby has hemoglobin F that transports more oxygen, also higher
hemoglobin to carry more o2 and a higher cardiac output. With preeclampsia, GDM, or anemia
these may be altered.
Cardiovascular: HR should be between 110-160. Preterm babies will have higher.
Pulmonary: Fetal lungs produce fluid to clear and allow normal air breathing after birth.
Catecholamine’s toward term are released to help breathing.
2) Passenger is the fetus, membranes and placenta.
Attitude: The relationship of fetal body parts to one another. The normal attitude is flexion to the
neck, arms and legs.
Fetal lie: The relationship of the longitudinal axis of the fetus to the longitudinal axis of the mother.
Vertex: (head first) most common - longitudinal
Breech: (buttocks first) –longitudinal. Sometimes occurs during preterm babies and babies
with hydrocephalous and placenta previa (placenta in the bottom [Show Less]