Intrapartal

• Components of Labor include Passage, Passenger, Powers of Labor, and Psychological Outlook.
• Passage refers to the route a fetus must travel from the uterus through the cervix and vagina to the external perineum.
• If the placenta does not deliver spontaneously, it can be removed manually.
• Fetal Danger Signs of Labor include high or low fetal heart rate, meconium staining, hyperactivity, and low oxygen saturation.
• Maternal Danger Signs of Labor include high or low blood pressure, abnormal pulse, inadequate or prolonged contractions, abnormal lower abdominal contour, and increasing apprehension.
• Passenger is the fetus, with the fetal cranium composed of eight bones: four superior bones: frontal, parietal, and the occipital, and four bones at the base of the cranium.
• Sutures include Sagittal Suture, Coronal Suture, Lambdoid Suture, and Fontanelles.
• Anterior Fontanelle, referred to as the bregma, is diamond-shaped and closes at 12-18 months.
• Posterior Fontanelle involves three bones: triangular-shaped and closes at 2 months of age.
• Fetal Head Diameter is measured in Molding, which is the overlapping of skull bones along the suture lines, caused by the force of uterine contractions, and lasts a day or two.
• Fetal Attitude describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other.
• Fetal Lie is the relationship between the long (cephalocaudal) axis of the fetal body and the long (cephalocaudal) axis of a woman’s body, with the fetus lying in a horizontal (transverse) or a vertical (longitudinal) position.
• The placental stage is divided into two phases: placental separation and placental expulsion.
• The latent or early phase of the first stage of labor begins at the onset of regularly perceived uterine contractions and ends when rapid cervical dilatation begins.
• The third stage of labor, the placental stage, begins with the birth of the infant and ends with the delivery of the placenta.
• Placental separation occurs when the length of the umbilical cord increases, there is a sudden gush of vaginal blood, the placenta is visible at the vaginal opening, and the uterus contracts and feels firm again.
• The active phase of the first stage of labor begins with rapid cervical dilatation, increasing from 4 to 7 cm at a rate of about 1 cm per hour in nulliparas and 2 cm per hour in multiparas.
• The transition phase of the first stage of labor occurs when contractions reach their peak of intensity, occurring every 2 to 3 minutes with a duration of 60 to 70 seconds.
• The second stage of labor is the time span from full dilatation and cervical effacement to birth of the infant.
• The fourth stage of labor begins with the birth of the placenta and continues for the first 1 to 4 hours after birth.
• Placental expulsion occurs after separation, the placenta delivers either by the natural bearing-down effort of the mother or by gentle pressure on the contracted uterine fundus (a Credé maneuver).
• The first stage of labor is divided into three segments: a latent, an active, and a transition phase.
• Fetal presentation denotes the body part that will first contact the cervix or be born first, with types including cephalic presentation, breech presentation, and shoulder presentation.
• Fetal Position is the relationship of the presenting part to a specific quadrant and side of a woman’s pelvis, with four parts of a fetus typically chosen as landmarks to describe the relationship of the presenting part to one of the pelvic quadrants.
• Engagement refers to the settling of the presenting part of a fetus into the pelvis, meaning the widest part of the fetus has passed through the pelvis or the pelvic inlet has been proven adequate for birth.
• Descent in labor refers to the movement of the fetus through the birth canal during the first and second stage of labor.
• Expulsion in labor is the delivery of the shoulders and remainder of the body.
• External Rotation in labor occurs when the sagittal suture moves to a transverse diameter and the shoulders align in the anteroposterior diameter.
• The Uterine Stretch theory states that any hollow body organ when stretched to its capacity will inevitably contract to expel its contents.
• Internal Rotation in labor aligns the rotation of the fetal head with the long axis of the maternal pelvis.
• Dilatation in labor refers to the enlargement or widening of the cervical canal from an opening a few millimeters wide to one large enough to permit passage of a fetus.
• The Theory of Aging Placenta states that advance placental age decreases blood supply to the uterus, triggering uterine contractions, thereby, starting the labor.
• The second stage of labor extends from the time of full dilatation until the infant is born.
• Effacement in labor refers to the shortening and thinning of the cervical canal during labor.
• The first stage of dilatation in labor begins with the initiation of true labor contractions and ends when the cervix is fully dilated.
• The Progesterone deprivation theory states that Progesterone is the hormone designed to promote pregnancy.
• The Powers of Labor are supplied by the fundus of the uterus and implemented by uterine contractions.
• Flexion in labor occurs when the chin of the fetus moves toward the fetal chest; it occurs when the descending head meets resistance from maternal tissues.
• The Oxytocin theory states that pressure on the cervix stimulates the hypophysis to release oxytocin from the maternal posterior pituitary gland.
• The Psyche refers to the woman’s psychological outlook or feelings a woman brings into labor.