Category: Maternal Neonatal Nursing The most vulnerable moment in childbirth is when the fetal head begins to stretch and distend the perineum. Instructing the mother to pant and not push slows the passage of the head and shoulders to prevent maternal injury.
Category: Maternal Neonatal Nursing Late decelerations are serious and often indicate uteroplacental insufficiency. The tracing contours are generally smooth, with the heart rate nadir occurring well after a maximal uterine contraction (typically ≥ 30 seconds afterward).
Category: Maternal Neonatal Nursing Variable and early decelerations normally represent physiologic reflexes associated with compression in the birth canal or cord compression. Variable decelerations that are persistent usually indicate repeated episodes of umbilical cord compression.
Category: Maternal Neonatal Nursing Decelerations in fetal heart rate are complicated. There are three types of deceleration: variable, early and late. These terms refer to the timing of the deceleration relative to the uterine contraction.
Category: Maternal Neonatal Nursing Accelerations occur during fetal movement and reflect an alert mobile fetus. Decreased variability may indicate fetal acidemia and hypoxemia or may be a side effect of a wide array of drugs, including analgesics, sedative-hypnotics and alcohol.
Category: Maternal Neonatal Nursing Electronic fetal monitoring uses tracings of the fetal heart rate and uterine activity. Documentation of organized cyclic uterine contractions helps confirm true labor and may help diagnose fetal distress.
Category: Maternal Neonatal Nursing The second stage of labor is characterized by a fully dilated cervix and the urge to bear down and push with each uterine contraction. The median duration of this stage is 50 minutes in nulliparous women and 20 minutes in multiparous women.
Category: Maternal Neonatal Nursing A rupture of membranes may reveal pooling of amniotic fluid, a fernlike pattern when the fluid is allowed to dry on a microscope slide and the use of Nitrazine paper, which should turn blue, indicating an alkaline amniotic fluid (pH > 6).
Category: Maternal Neonatal Nursing The abdominal examination with Leopold’s maneuvers may be able to confirm the lie of the fetus. Although after labor has begun, Leopold’s maneuvers may not easily distinguish the lie due to uterine contractions.
Category: Maternal Neonatal Nursing The maternal examination provides a rough guide to gestational age. At 20 weeks’ gestation, the uterine fundus reaches the umbilicus. Approximately 1 cm of fundal height is added per week of gestation until 36 weeks.
Category: Maternal Neonatal Nursing The duration of the first stage of labor averages 8 hours in nulliparous women and 5 hours in multiparous women. During this time, assessment of fetal well-being is important and external electrical monitoring may help identify fetal distress.
Category: Maternal Neonatal Nursing The first stage of labor is the cervical stage, ending with a completely dilated, fully effaced cervix. It is divided into a latent phase, with slow cervical dilation and an active phase, with more rapid dilation.
Category: Maternal Neonatal Nursing At the onset of labor, the cervical mucous plug may be expelled, resulting in what is termed a bloody show. The bleeding associated with this process is slight (usually only a few dark red spots admixed with mucus).
Category: Maternal Neonatal Nursing True labor is characterized by cyclic uterine contractions of increasing frequency, duration and strength. In contrast to Braxton Hicks contractions, true labor causes cervical dilation to begin, marking the first stage of labor.
Category: Maternal Neonatal Nursing Braxton Hicks contractions do not escalate in frequency or duration, in contrast to the contractions of true labor. By definition, these contractions are associated with minimal or no cervical dilation or effacement.
