MATERNITY NORMAL VALUES

  • Fetal Heart Rate: 120 – 160 bpm
  • Variability: 6 – 10 bpm
  • Amniotic fluid: 500 – 1200 ml
  • Contractions: 2 – 5 minutes apart with duration of
    < 90 seconds and intensity of <100 mmHg
  • AVA: The umbilical cord has two arteries and one vein
  • Pregnancy induced HTN
    • HTN, proteinuria, edema

VEAL CHOP
[fetal heart monitoring]

V – variable deceleration C – cord compression
E – early deceleration H – head compression
A – acceleration O – okay/ O2
L – late deceleration P – placental insufficiency


EPIDURAL ANESTHESIA: STOP

  • STOP is a treatment for maternal hypotension after an epidural anesthesia
    Stop infusion of Pitocin
    Turn the client on her left side
    Oxygen therapy
    Push IV fluids, if hypovolemia is present

RH FACTOR

  • Rhogam vaccine is for moms who are Rh negative
    • Given at 28 weeks pregnant &
    • Within 72 hours after giving birth


STAGES OF LABOR

1st Stage of Labor
Effacement (thinning) and Dilation (opening) of the cervix
Cervix will widen to about 10 centimeters total during the 1st stage of labor
First stage of labor usually lasts about 12-13 hours for a mother’s first baby & 7 to 8 hours for a second child

The first stage of labor has three parts:
1. Early labor
Cervix @ 4 centimeters
Contractions may go away if you change activity, but over time they’ll get stronger
2. Active labor
Cervix @ 4 to 7 centimeters
Contractions every 3-4 min and they each last about 60 seconds à cervix opening ~ 1 cm/hr now
Water breaks (ruptured membranes)
3. Transition to second stage
Cervix @ 7 to 10 centimeters
Typically Hardest/most painful part of labor
Contractions last about 60 to 90 seconds and come every 2 to 3 minutes

2nd Stage of Labor
Baby moves through the birth canal
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of the baby
Contractions push the baby down the birth canal
The intensity at the end of the first stage of labor will continue in this pushing phase

3rd Stage of Labor
Afterbirth
After the birth of the baby, the uterus continues to contract to push out the placenta (afterbirth)
The placenta usually delivers about 5 -15 minutes after the baby arrives

4th Stage of Labor
Recovery

Average Blood Loss During Childbirth
Vaginal Birth – 500 mL/ C-Section – 1000 mL


APGAR SCORING

  • APGAR (each scored from 0-2)
    • Appearance (skin color)
      • 1 for pink body w/ blue extremities à normal
    • Pulses (HR)
      • 1 = <100, 2 = >100
    • Grimace (reflex irritability)
    • Activity (muscle tone)
    • Respiration
      • 2 = vigorous cry
  • Completed at 1 minute & 5 minutes of life
  • Scores:
    • Normal: 7 and above
      • 9 is considered “perfect”, 10 is nearly impossible because of normal blue hands and feet
    • Fairly Low: 4 to 6
    • Critically Low: 3 and below


MISCELLANEOUS MATERNITY/ NEWBORN INFORMATION

  • Infants born to an HIV-positive mother should receive all immunizations of schedule
  • Gravida is the number of pregnancies a woman has had, regardless of outcome
  • Para is the number of pregnancies that reached viability, regardless of whether the fetus was
    delivered alive or stillborn. A fetus is considered viable at 20 weeks’ gestation
  • Lochia
    • Lochia rubra is the vaginal discharge of almost pure blood that occurs during the first few days after childbirth.
    • Lochia serosa is the serous vaginal discharge that occurs 4 to 7 days after childbirth.
    • Lochia alba is the vaginal discharge of decreased blood and increased leukocytes that’s the final stage of lochia. It occurs 7 to 10 days after childbirth.

 

*** Disclaimer: I composed this study guide myself but the information is from other resources.