Descent is spoken in terms of the station that the fetus is in. Flexion is that chin to chest to help the fetus move it’s way out. Now descent, so the fetus is moving further towards the “exit” and flexion of the head occurs. This can happen a few weeks before delivery and is also known as “lightening”. This is the head in the pelvis engaged in and not moving back up. These are the movements that the fetus does to find its way out. The mechanisms of labor are known as the cardinal movements. In this lesson I will explain how labor and the delivery occurs and your role in assisting the patient in a successful delivery. False: Contractions are not regular, do not get stronger or closer together, stop with rest, hydration, and activity.True: contractions can be timed regular, get stronger and closer together, do not stop with rest or activity.Amniotic fluid has a pH of 7-7.5 and will turn test strip blue.May need to perform Nitrazine test to determine if mother has urinated or ruptured membranes.Fetal head will be on cervix and will stimulate uterine contractions and therefore labor Absence of the buffer of the amniotic fluid in uterus.AROM: artificial rupture of membranes Done with a tool or hand of physician.ROM: spontaneous rupture of membranes at full term.Bacteria gets in because prolonged rupture.Greatest risk to baby occurs when this occurs before 37 weeks.PPROM: Preterm premature rupture of membranes.Estrogen and progesterone levels fluctuate, causing a fluid shift and subsequent weight loss of 2.2-6.6 kg approximately 24-48 hrs prior to labor.Burst of energy can occur 24-48 hrs before (“nesting”).Cervix gets ready by ripening, potentially dilating/effacing.Brown/blood tinged cervical mucus passes.Other events that occur just before labor occurs.False labor does not do any of the above.True labor produces dilation, effacement, engagement and descent.If mom changes activity (going from resting to walking) and the contractions stop, it is FALSE labor.True labor is progressive, regular, and becomes stronger.Restitution and external rotation : occur simultaneously as a fluid movement.Internal rotation : baby rotates within the birth canal.0 station = presenting part at ischial spine.Descent is measured by station, continuous process until delivery.Descent and flexion : process of presenting part (typically the head) going through mom’s pelvis, occur simultaneously as a fluid movement.Occurs approximately 2 weeks before delivery.Engagement : where the presenting part descends through the pelvic inlet.It is important to be able to differentiate between true vs.The uterus is a muscle and it contracts to prepare for childbirth.Occasionally referred to as the Cardinal Movements.Fetus has to be well engaged and mom in true labor to be successful. This all happens fluidly during the process of delivery.Cardinal movements-specific movements the baby does, in this specific order, to exit mom successfully.
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