T3 Labor, Birth, and Pain Management

• What is considered the end of pregnancy and the processes that lead to birth of the baby?

  Labor.
• What is the passenger in labor?

  Fetus.
• What affects how the passenger moves through the birth canal?

  • Size of fetal head
  • Fetal presentation
  • Fetal lie
  • Fetal attitude
  • Fetal position
• Where are sutures present on the fetal head?

  Where 2 bones meet.
• Where are fontanels on the fetal head?

  Where more than 2 bones meet.
• When does the anterior fontanel close?

  18 months
• When does the posterior fontanel close?

  Around 6 - 8 weeks after birth.
• How does the nurse determine fetal presentation, position, and attitude during a vaginal exam?

  Cranial landmarks.
• In order of greatest to least, what is the most to least common fetal presentation?

  1. Cephalic (~ 97%) 2. Breech (~ 3%) 3. Shoulder (~ <1%)
• What kinds of fetal lie are there?

  Longitudinal or vertical, horizontal, transverse, oblique.
• Which fetal lies are not compatible with vaginal delivery?

  Horizontal, transverse, oblique.
• Which fetal lie can be cephalic or breech?

  Longitudinal or vertical.
• What is a frank breech?

  A breech presentation where the baby's buttocks are closest to the birth canal.
• What is a complete breech?

  Breech presentation where sacrum with feet are closest to the birth canal.
• What is a single footling breech?

  Sacrum at the pelvis with one of the legs already out of the pelvis.
• What is fetal attitude?

  Relation of fetal parts to each other.
• What is the characteristic posture for fetal attitude?

  General flexion with chin resting on chest.
• Why is the fetal attitude best with chin resting on chest?

  Results in vertex position which is the smallest diameter of the fetal head passing through the maternal pelvis.
• Which of the three presentations of fetal attitude is the smallest diameter?

  Vertex.
• What is sinciput presentation for a fetus?

  Extension of the head with the 2nd largest diameter entering the pelvis.
• What is brow presentation for a fetus?

  Complete extension of the head with the largest diameter entering the pelvis.
• What is the station or degree of descent?

  Relation of the presenting fetal part to an imaginary line drawn between the maternal ischial spines to measure how much of the fetus is through the birth canal.
• What is the range of the scale for station?

  -5 to 5.
• What number for station is where the ischial spine is?

  0.
• What is sinciput?

  Forehead.
• What is mentum?

  Chin.
• What is vertex on the fetal head?

  Top and back part of head.
• What is occiput?

  Back of the head.
• What number is considered the station for fetal presentation?

  0.
• When is birth imminent in regards to station?

  4+ to 5+.
• Are positive or negative number stations indicative of above the ischial spines?

  Negative.
• What is the passageway during birth?

  Birth canal.
• Gynecoid passageway shape is most often associated with OA presentation.
• What shape is gynecoid passageway?

  Shape: Round, Side walls: Straight, Suprapubic arch: Wide.
• Android passageway shape is most often associated with a higher risk of CPD.
• Anthropoid passageway shape is most often associated with OP presentation.
• What shape is android passageway?

  Shape: Heart, Side walls: Convergent, Suprapubic arch: Narrow.
• What shape is anthropoid passageway?

  Shape: Oval, Side walls: Straight, Suprapubic arch: Narrow.
• What shape is platypelloid passageway?

  Shape: Flat, Side walls: Straight, Suprapubic arch: Wide.
• Platypelloid increases the likelihood of transverse arrest.