NCM 107: MATERNAL & CHILD HEALTH NURSING
1st SEMESTER MIDTERM REVIEWER
LABOR & DELIVERY
Q: What is the correct order of the cardinal movements?
A: 1. Engagement, Flexion Descent
2. Internal Rotation
3. Extension
4. External Rotation
5. Expulsion
SIGNS OF LABOR
thinning of the cervix (effacement)
opening of the cervix (dilation)
increase in vaginal discharge
water breaks (rupture of membranes)
FETAL POSITION
Definition: Relationship of presenting fetal part to the quadrants of maternal pelvis;
vertex (most common), occiput anterior or maternal left side (LOA)
BIOETHICAL PRINCIPLES
BLODD LOSS DURING DELIVERY
The average amount of blood loss after the birth of a single baby in vaginal
delivery is about 500 ml (or about a half of a quart).
The average amount of blood loss for a cesarean birth is approximately 1,000
ml (or one quart).
STAGES OF LABOR
FIRST STAGE
Begins with true labor CTX & ends when the cervix is full dilated.
Three (3) Phases of the FIRST STAGE of Labor
Latent (preparatory) Phase - 0-3cm
Active Phase - 4-7cm
Transition Phase - 8-10cm
SECOND STAGE
Period when the cervix is completely dilated & effaced to the birth of the infant.
"Pushing Stage"
DONT push until the urge to push presents!
THIRD STAGE
Begins with birth of baby & ends with the delivery of the placenta.
Expulsion of placenta by natural bearing down/gentle pressure on the fundus &
gentle traction on the cord.
FOURTH STAGE
The period from 1 - 4 hours after birth.
Bleeding problems arise most often in 1st HR post-delivery!
BREASTFEEDING
FETAL HEART TONE (FHT)
Normal: 110 bpm – 160bpm
STATIONS
Definition: Relationship of presenting part to ischial spines.
Floating: presenting part above pelvic inlet
- station -5: presenting part at the inlet
- station 0: presenting part at the IS
- station +4: presenting part at the outlet
UMBILICAL CORD COMPRESSION
Definition: The umbilical cord is formed from the fetal membranes, the amnion and
chorion, and provides a circulatory pathway that connects the embryo to the chorionic
villi of the placenta.
1st clamp – 2cm from the umbilical base
2nd clamp – 3cm from the 1st clamp
Q: What week does the umbilical cord forms?
A: first 5 weeks of gestation
Q: At what week can it be visualized sonographically?
A: 8th week
Q: What is the essential link for oxygen and nutrients among fetus, placenta, and
mother?
A: umbilical cord
Q: What vessels does a normal umbilical cord contain?
A: 2 arteries and 1 vein
Q: Which umbilical vessel carries oxygenated blood to fetus?
A: umbilical vein
Q: Carry deoxygenated blood from the fetus back to the placenta
A: umbilical arteries
Q: the normal cord diameter is cm
A: 1cm-2cm
Q: the normal cord length is cm
A: 40cm-60cm
Q: the forms the outer covering of the umbilical cord
A: amniotic membrane
DILATATIONS
ALPHA PROTEIN
Definition: AFP stands for alpha-fetoprotein. It is a protein made in the liver of a
developing baby.
SIGNS OF PLACENTAL SEPARATION
1. umbilical cord lengthens
The most reliable sign is the lengthening of the umbilical cord as the placenta
separates and is pushed into the lower uterine segment by progressive uterine
retraction.
2. gush of blood
3. firm/globular uterus
4. uterus rises to the abdominal wall
LOCHIA
Definition: Vaginal discharge resulting from involution and endometrium regeneration;
characterized by rubra, serosa, and alba; should not have a foul smell.
Lochia amounts: Average amount is 225 mL; Varies with parity, type of delivery,
breastfeeding, and activity levels.
Types of LOCHIA Color Postpartal Day/s
Lochia Rubra RED 1-3 days
Lochia Serosa PINK 3-10 days
Lochia Alba WHITE 10-14 days
Classifications of lochia amounts
Scant less than 1 inch stain on pad
Light 4 inch or less stain
Moderate 4-6-inch stain
Large/Heavy saturated pad in less than 1 hour
Excessive saturated pad in 15 minutes
VITAL SIGNS (VS)
TEMPERATURE – 97.6°F - 98.6°F axillary
HEART RATE – 120 bpm - 140 bpm
RESPIRATIONS – 30 - 60 breathes per minute
MEASUREMENT OF INFANT
HEAD CIRCUMFERENCE – 34cm - 35cm
CHEST CIRCUMFERENCE - 2cm - 33cm
WEIGHT – 2.5 kg - 3.4 kg
LENGTH – 46cm - 54cm
Rhogam
GROWTH & DEVELOPMENT
