Midwifery

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1. 1st degree includes skin, subcutaneous tissue, vaginal 17. assessing palpate inbetween contractions, determine
tear mucosa. progress of descent of presenting part, identify lie,
labour-abdo presentation, position, engagement, descent.
2. 2nd degree superficial perineal muscles, perineal body,
exam FHR.
tear deep perineal muscle.
18. assessing position, consistency, effacement, dilatation,
3. 3rd degree superfical and deep muscles and anal
progress of application, presenting part-position, station,
tear sphincter
labour- caput/moulding, membranes-intact, bulging
4. 4th degree superficial and deep muscles and anal cervix or ruptured, colour of liquour, FHR.
tear sphincter, and or internal anal sphincter and
19. assessing measure strength, intensity, length and
anorectal epithelium.
progress of frequency, measured and documented for ten
5. 5 increased blood volume, BP same or drops, labour- mins each half hour.
cardiovascular increased blood flow to skin=sweating, contractions
changes in flushed. drop in HB. iron stores fall.
20. assessing blood stained, mucous stained indicates
pregnancy
progress of progress of labour, detachment of
6. 5 respiratory increase basal metabolic rate, increased labour- membranes as cervix dilates, ROM can occur
changes in oxygen consumption, flaring of ribs, raised vaginal loss any time, report mech stained liquor=fetal
pregnancy position of diaphragm, sleep disorders, distress. offensive smell=infection.
snoring.
21. assessing descent, flexion, anterior rotation of fetal
7. accelerations the transient increase in FHR of 15bpm, or progress of head, softening and effacement, dilatation of
more above the baseline lasting at least labour- VE cervix, application of cervix to presenting
15seconds. part, vaginal abnormalities.
8. active oxytocic agent used such as syntometrine, 22. Attitude The relationship of the fetal head and limbs
managment controlled cord traction. to the fetal trunk.
of third stage
23. baseline CTG Normal FHR is 110-160, the mean level of the
9. Active phase cervix dilates approx 3-8cms, contractions FHR at rest, in the absence of fetal
of labour are regular, stronger, closer together, movement, uterine activity, accelerations and
10. Advantages no side effects from oxytocic agent, early decelerations.
of breastfeeding, umbilical cord can be left til 24. bones of occiput, 2 parietals, 2 frontals
physiological no pulsation. fetal skull
management
25. bones of the 2 innominate hip bones, one sacrum, one
11. the aims of observe signs of pregnancy, assess fetal size pelvis coccyx
the abdominal and growth, assess fetal health, diagnose
26. braxton hicks contractions in the uterus during pregnancy
examination and locate fetal parts, detect any deviations
contractions which are painless.
from normal.
27. BRIM anterior/posterior = 11, oblique = 12,
12. android least favourable for childbirth, male pelvis,
transverse= 13
heart shaped brim, straight sacrum, cant
easily accomodate the biparietal diameter. 28. caput occurs on the fetus scalp as a result of
succedaneum odema from obstructed venous return and
13. Antenatal time of conception until the onset of labour.
pressure on the birth canal.
period
29. Cardinal Descent, Flexion, Internal rotation, Extension,
14. anterior is normal presentation which is face down.
Movements Resititution, External rotation, Expulsion.
15. anterior at the sagittal, coronal and frontal sutures,
30. care in the create an environment conductive to meet
fontanelle diamond shape VE= fetal head not well
active phase the womans needs, assessment and
flexed(large circumference trying to get
of labour documentation related to risk factors,
through).
provide supportive care, assessment and
16. anthropoid long oval brim, doesnt usually cause documentation related to progress.
problems in labour, may favour occipito-
31. care in the encourage woman to stay at home, walk
posterior position
latent phase around, eating, hydration, activities or rest,
of labour agree on plan for next stage.
32. CAVITY anterior/posterior=12, Oblique =12, transvers = 48. an example of flexed, deflexed or partially or completey
12. the fetus extended
attitude is
33. controlled active management- only do it if oxytocic
cord traction agent is given, ensure uterus in well 49. explain feto- deoxygenated blood is bought to the
contracted, guard the uterus, place cord placental placenta via 2 umbilical arteries, return
clamp close to the intoritus, apply circulation circulation is by way of the umbilical vein
downward continuous steady traction to the which carries oxygenated blood back to
cord via the cord clamp, once placenta is the fetus.
seen move upwards.
50. Expulsion maternal pushing efforts bring the anterior
34. coronal seperates the parietal and frontal bones shoulder under the symphysis pubis,
suture lateral flexion of the shoulder and head
occurs, and then the anterior then
35. crowning when the babys head has passed through the
posterior shoulder appears, once the
birth canal and the top or crown stays visible
shoulders are delivered the body quickly
at the vaginal opening.
follows.
36. CTG fetal assesment, trace of fetal heart rate and
51. Extension as the fetal head passes under the
maternal contractions.
maternal symphysis pubis, it meets with
37. decelerations decrease FHR below the baseline of more resistance from the pelvic floor. the head
than 15bpm lasting at least 15seconds. may pivots and extends with each maternal
be early, variable, prolonged or late. pushing effort, the head is born in
38. definate ultrasound, fetal parts palpated, Fetal heart. extension, with the face directed towards
signs of the rectum.
pregnancy 52. fabourable/ripe the cervix is soft and is considered
39. Denominator A fixed point on the presenting part used to cervix favourable for labour
describe position. 53. fetal intermittent auscultation after a contraction,
40. Descent progression of the fetal head into pelvis, assessment FHR every 30mins, liqour assessment each
measured in stations. during labour 30mins when ROM.

41. Dilatation the extent to which the cervix has opened in 54. fetal axis force of the fundal contraction is
preparation as a result of uterine pressure transmitted to the upper pole of the fetus
contractions, full dilatation is 10cm. down to the long axis of the fetus

42. effacement this refers to the thinning of the cervix in 55. first stage of begins with the onset of labour until
preparation for birth and is expressed in labour complete dilatation of the cervix
percentages. Mum needs to be 100% effaced 56. Flexion occurs as the fetal head descends and
to be able to push. comes into contact with the soft tissues of
43. the effects of CNS depression, deep fetal sleep, drugs, the pelvis, the resistance of these structures
decrease prematurity, hypoxia. causes the fetal chin to flex down to its
variability on chest, which allows the smallest fetal
the fetus is? diameters to enter the maternal pelvis.

44. Engagement The largest diameter of the presenting part 57. forewaters bag of membranes and liquor in front of
has passed through the pelvic brim. Pelvic the presenting part
brim widest from side to side. At the level of 58. four different gynacoid (ideal for child bearing), android
the ischial spines 0 = engagement. types of pelvis (least favourable, male pelvis), anthropoid
45. epidural a common method of analgesia used during are? (long oval brim), platyoelloid (increased
labour. it is inserted through a catherter risk of obstruction).
which is threaded through a needle, into the 59. frontal suture divides the frontal bones
dura space in the spinal cord.
60. function of allows growth and movement, protects the
46. episiotomy an incision made in the perineum to widen amniotic fluid fetus from injury, maintains constant temp,
the vaginal opening for delivery. provides small amount of nutrients, during
47. estimation of distance beween the top of the uterus and labour it protects the placenta and cord
fundal height the upper border of the symphysis pubis from contractions, aids effacement and
dilatation of cervix.
61. function of Protection, Respirations, Excretion, Endocrine, 75. in a cephalic occiput
the placenta Nutirtions, Storage presentation
the
62. the functions holds pelvic organs in place, maintains intra
denominator
of the abdominal pressure, voluntary control of
is the
muscles of defacaetion, facilitates the movement of the
the pelvic fetus in childbirth, enables flexion of the 76. in a face mentum
floor coccyx and sacrum presentation
the
63. Fundal The greatest strength of contractions occurs
denominator
dominence in the fundus of the uterus, moving down the
is the
upper segment in diminishing strength
77. Internal as fetal head continues to descend it must
64. goals of reduce blood loss, reduce risk of PPH,
rotation rotate to accomodate changes in the width of
active shorten the 3rd stage of labour, enhances the
the pelvic opening. Pelvic cavity is widest
managment physiological processes.
front to back.
of third stage
78. in the 32nd cephalic (head down)
65. goals of informed choice re: active or physiological
week what
management management, deliever placenta and
position
of 3rd stage membranes completely, achieve minimal
would the
of labour blood loss, leave the uterus empty and
fetus be in
contracted.
79. in the late longitudinal
66. Grande a woman in her fourth or subsequent
stages of
Multigravida pregnancy but who has not necessarily borne
pregnancy
live children in previous pregnancies.
the lie
67. Grand a woman of high parity usually one who has should be
multipara borne 4 or more children
80. involution return of the uterus to its pre-pregnant state
68. Gravid pregnant
81. ischial lies above the ischial tuberosity, inward
69. gynaecoid ideal for childbearing, rounded brim, spines projections, situation of fetal head is estimated
generous forepelvis, shallow cavity, blunt in terms of centimeters above or below.
ischial spines.
82. ischial is a large prominence when the body rests
70. hindwaters liquor contained in the uterus behind the tuberosity when sitting
presenting part
83. lamboidal lies betwene the occiput and parietal bones
71. hip bone are illium (large flared out part), ischium (thick suture
made up of: lower part) and pubic bone.
84. latent phase in first stage of labour- beginning of effective
72. human secreted by trophoblast, stimules corpus of labour labour, effacement and dilatation, until 3cm
chorionic luteum to produce oest/prog until placenta dilatate, irregular contractions, braxton hicks,
gonadtrophin takes over. stops the mum rejecting the baby, early labour!
(hCG) values are present in maternal urine-
85. lateral hands are placed on either side of the uterus
pregnancy test, causes morning sickness
palpation at the umbi, gentle pressure applied to see
73. human begins 5-10days after implantation, facilitates which side offers greater resistance=fetal
placental growth, low levels are facilitated with back, fingertips of both hands are walked
lactogen miscarriage. over the uterus, palpate to identify fetal poles
(hPL) (head and bottom).
74. in a breech bottom 86. Lie the relationship of the long axis of the fetus to
presentation the long axis of the uterus
the
87. ligaments of intepubic, sacroiliac, sacrococcygeal,
denominator
the pelvis sacrotuberous, sacrospinous.
is the
88. lightening the presenting part enters the pelvis usually
after 36weeks
89. liquor amniotic fluid
90. lower lower part of the uterus in pregnancy 107. Parous a woman who has borne one or more
uterine developed from the isthmus and cervix viable offspring
segment
108. partograph provides graphical record of the
91. Maternal illness or injury from the time of conception progression of labour, particularly the
morbidity until the end of the puerperium and attributed dilatation of the cervix. progress can
to childbirth. be assessed from the visual patterns of
cervical dilatation and descent of the
92. Maternal death from the time of cenception until the
presenting part in conjunction with the
mortality time completion of the puerperium and
record of the maternal and fetal
attributed to childbirth.
wellbeing.
93. maternal 4hrly BP, Temp. 1/2 hourly maternal pulse,
109. Pawlics Palpation the midwife grasps the lower pole of
risk fluid input and output. vaginal loss.
the uterus between her finger and
assessment
thumb, used to identify the pole
on going
(bottom or head) and whether it is
94. Mechanisms Passive movements of the fetus as it passes fixed in the pelvis, can be
of labour through the birth canal, adapting to the shape uncomfortable for the woman.
of the maternal pelvis.
110. physiological no intervention, no drugs, may be with
95. mechanisms descent with engagement, flexion, internal management of or without cord clamping, maternal
of labour rotation, extension, resititution, external third stage effort, 20min-1hour, with or without
rotation, lateral flexion nipple stimulation.
96. Mechanisms LIE=longitudinal, PRESENTATION=cephalic, 111. Physiological the line of demarcation which
of normal POSITION=ROA or LOA, ATTITUDE=flexed, retraction ring develops at the junction of the upper
birth DENOMINATOR=occiput. and lower uterine segment in normal
97. moulding alteration in the shape and diameteres of the labour
fetal head during labour 112. platypelloid increased risk of obstruction, kidney
98. Multigravida a pregnant woman who has had previously shaped brim.
more than one pregnancy. 113. polarity co-ordination between the upper and
99. Multipara a woman who has borne more than one viable lower uterine segments during normal
infant labour

100. neonatal pertains to the first four weeks after birth 114. Position The relationship of a denominator to
period the quadrants of the maternal pelvis
eg. left occipto anterior (LOA)
101. Normal A process by which the fetus, placenta and
labour membranes are expelled through the birth 115. possible exclusion low HB, previous PPH, prolonged
canal. normal labour begins spontaneously guidelines for labour, precipitate labour, large fetus,
without intervention, with the fetus presenting physiological bleeding.
by the vertex-duration 4-24hours. management

102. Nullipara a woman who has never given birth to a 116. posterior the baby is in a face up position during
viable child but may have been pregnant. delivery.

103. the 1/ POWER=uternie contractions 2/ 117. posterior at lamboidal and sagittal suture, is
outcome of PASSENGER=fetus size and presentation 3/ fontanelle triangular shaped, if felt on VE=fetus
labour is PASSAGES=cervix, bony pelvis, tissues 4/ head well flexed, used to indicate the
dependent PSYCHE=knowledge, expectations, support, relationship of the fetal skull to the
on the 4 P's environment. mums pelvis

104. OUTLET anterior/posterior = 13, oblique = 12 transverse 118. Post the period taken for the reproductive
= 13 Partum/Puerperium organs to return to their pregravid state
which is usually six weeks following
105. oxytocic any drug that stimulates contractions of the
childbirth
uterus in order to induce or accelerate labour
119. preparation for the explanation, informed consent, empty
106. Para this term is used to describe a woman who
abdominal bladder, privacy, clean and warm
has produced one or more living children
examine includes hands
120. Presentation The part of the fetus which lies in the 134. signs of no palpable cervix felt on VE, urge to push,
lower segment of the uterus. second bloody show, change in contractions, bowel
stage pressure, anal pouting, perineal stretching,
121. Pre term labour onset of labour before 37weeks of
audible grunting, increase vocalisation.
pregnancy.
135. skeletal progesterone relaxes ligaments and muscles,
122. Primigravida a woman pregnant for the first time
changes in increasing pelvic capacity, pelvis is widened
123. Primipara a woman who has give birth to a pregancny and the coccyx is pushed out of the way in
viable infant, living or stillborn. labour, lordosis of spinal column.
124. probable signs of N&V, tiredness, period stopped, 136. Station refers to the level of presenting part in
pregnancy increased appetite and thirst, sore relation to the maternal ischial spines, whihc
breasts. increased urination. represent the narrowest diameter through
125. progesterone acts on smooth muscles, promotes which the fetus must pass, +stations indicates
breast development and growth that the presenting part of the fetus has
descended past the ischial spines.
126. renal changes in increase metabolic waste, relaxation
pregnancy of smooth muscles affect bladder 137. sutures of lamboidal, sagittal, coronal, frontal
and ureters- potential for urine stasis. fetal skull

127. reproductive enlargement of the uterus, softening 138. third stage from the birth of the infant until the placenta
changes in of the cervix, engorgement of the of labour and membranes are delivered
pregnancy vagina, growth and development of 139. Three main inspect- uterine size and shape, skin changes.
breasts. compents of palpate-fundal height, lateral palpation,
128. Resistution/External after the head is delivered in the abdo exam pelvic palpation. Auscultation-FHR.
rotation extended position it rotates briefly 140. transitional 8-10cms dilated, bloody show, restless
toward the position it occupied labouring woman. fully effaced
earlier in the pelvic inlet, realligning
141. two phases passive-no maternal urge to push, presenting
the head with the long axis of the
of second part is still high and active- fetal head is low
body. As resititution continues the
stage triggers the maternal urge to bear down,
shoulders allign in the
involuntary pushing.
anteriorposterior diameter, causing
the head to turn futher to one side, 142. upper the upper part of the uterus in pregnancy
the fetus then moves through the uterine developed from the body.
pelvis with the anterior shoulders segment
descending first.
143. variability the minor fluctuations in baseline FHR of 5-
129. retraction the process of permanent and 25 beats in amplitude. Inteaction between
pregressive shortening of the muscles parasympathetic and sympathetic nervous
of the uterus which accompanies system. indeicates adequate fetal perfusion.
contractions during labour- to dilate
144. Viable capable of independent life
the cervix, to expel the fetus and to
expel the uterus, membranes and to 145. what are the one symphysis pubis, two sacroilliac joints
control bleeding. joints of the and one sacrococcygeal joint.
pelvis
130. sagittal suture divides the parietal bones
146. what is a is an agent or influence that causes physical
131. secondary powers abdominal muscles, diaphragm used
teratogen defects in the developing fetus.
to push in second stage of labour
147. what is the a bony structure which articulates with the
132. second stage of from complete dilatation of the cervix
pelvis 5th lumbar vertebra with each femur head
labour until the birth of the infant
148. Why do an to observe pregnancy, assess fetal size, fetal
133. signs of descent of firm contraction of uterus, decreased
abdominal growth, location of fetal parts, detect
placenta size of fundus, alteration in the shape
examination? deviations from normal,
and mobility of the uterus,
lengthening of the umbilical cord,
gush of blood.