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Power
PRENATAL, LABOR/ DELIVERY AND  Uterine contractions
POSTPARTUM CARE  Voluntary bearing down
 Abdominal muscle contractions
 Contractions of levator ani muscle
A. STAGES OF HUMAN PRENATAL
2. Passageway
DEVELOPMENT
3. Passenger
1. First 12-14 days – zygote
 Attitude
2. 15th day – 8th week – embryo
 Engagement
3. 8th week – time of birth – fetus
 Position
 Presentation and presenting part
B. GERM LAYERS
 station
1. Endoderm
4. Person
2. Mesoderm
3. Ectoderm
J. THEORIES OF LABOR ONSET
1. Uterine Stretch Theory
C. NORMAL WEIGHT GAIN (20-25 lbs)
2. Oxytocin Stimulation Theory
1. 1st trimester – 1.5-3 lbs
3. Progesterone Deprivation Theory
2. 2nd trimester – 10-11 lbs
4. Prostaglandin Theory
3. 3rd trimester – 8-11 lbs
5. Theory of Aging Placenta
D. DANGER SIGNS DURING PREGNANCY
K. PRODROMAL SIGNS OF LABOR
1. Vaginal bleeding
1. Lightening
2. Persistent vomiting (hyperemesis gravidarum)
2. Loss of weight
3. Chills and fever
3. Increased level of activity (nesting)
4. Sudden escape of fluid from the vagina
4. Braxton-Hick’s contractions
5. Ripening of the cervix
E. EXERCISE DURING PREGNANCY
6. Rupture of the membranes
1. Promote comfort
7. Bloody Show
2. To facilitate labor and delivery
3. To strengthen muscles so that they will revert to
L. SIGNS OF LABOR
normal condition and functioning, quickly and
1. Uterine contractions
efficiently following childbirth
2. Effacement
3. Dilatation
F. BASIC PRENATAL EXERCISES
4. Uterine changes
1. Basic breathing exercises
2. Contraction and relaxation of pelvic floor muscle
M. FALSE LABOR PAINS
3. Basic pelvic rocking exercises for good posture
1. Remain irregular
4. Postural education
2. Confined to abdomen
5. Basic pelvic tilting laterally
3. No increase in duration, frequency and intensity
6. Basic pelvic rotation
4. Often disappear if the woman ambulates
7. Positions
5. Absent cervical changes
8. Muscle control and relaxation technique
9. Basic food exercises
N. TRUE LABOR PAINS
10. Stretching and Relaxing
1. May be slightly irregular to regular and
predictably
G. WOMAN’S EMOTIONAL RESPONSES TO
2. First felt in lower back and sweep around to
PREGNANCY
abdomen
1. Narcissism or self-centeredness
3. Increasing frequency, duration and intensity
2. Extroversion
4. Continuous
3. Inability to make decisions
5. (+) Effacement and dilatation
4. Emotional liability
5. Changes in sexual desires
O. EFFECTS OF LIGHTENING
1. Shooting pains down the legs
H. SCHEDULE OF CLINIC VISITS
2. Increased lordosis
1. First 7 months – once a month
3. Increased amount of vaginal discharge
2. 8th month – every other week
4. Resurgence of a sign of pregnancy
3. 9th month – every week

I. FOUR P’S OF LABOR

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P. CONSEQUENCES OF SPONTANEOUS
RUPTURE OF MEMBRANES X. INTERVENTIONS FOR NON CONTRACTED
1. Labor is inevitable UTERUS
2. If (-) labor  need for induction 1. Massage
3. (+) umbilical cord compression 2. Ice compress
3. Oxytocin administration
Q. STAGES OF LABOR 4. Emptying of the bladder
1. Dilatation 5. Bimanual compression
2. Complete dilatation to delivery 6. Hysterectomy
3. Placental stage: delivery of baby  placenta
4. Homeostasis: 1-2 hours post delivery Y. THREE LEADING CAUSES OF MATERNAL
MORTALITY
R. MECHANISMS OF LABOR 1. Hemorrhage
1. Descent 2. Infection
2. Flexion 3. Toxemia
3. Internal Rotation
4. Extension Z. POSTPARTUM INFECTIONS
5. External rotation 1. Infection of the perineum
6. Expulsion 2. Mastitis
3. Endometritis
S. DANGER SIGNS DURING LABOR AND 4. Thrombophlebitis
DELIVERY
1. Vaginal bleeding NEWBORN CARE
2. Premature labor
3. Abnormal fetal presentation A. PRINCIPLES OF NEWBORN CARE
4. Ruptured membranes 1. Establish and maintain a patent airway
5. Crowning 2. Maintain appropriate body temperature
3. Immediate assessment of the newborn
T. TWO PHASES IN THE THIRD STAGE OF 4. Proper identification
LABOR 5. Nursery care
1. Placental separation
2. Placental expulsion B. METHODS OF ESTIMATING AOG
1. Naegel’s Rule – LMP – 3 months + 7 days
U. SIGNS OF PLACENTAL SEPARATION 2. McDonald’s Rule – fundic height / 4 = AOG in
1. Firm and round uterus months
2. Sudden gush of blood 3. Bartholomew’s Rule – AOG based on fundic
3. Lengthening of the umbilical cord location
4. Quickening
V. LEOPOLD’S MANEUVER 5. FHT
1. LM1 – presentation 6. Ultrasound
2. LM2 – feet and back (fetal lie) 7. Assessment of newborn at birth
3. LM3 – engagement
4. LM4 – attitude C. ANTHROPOMETRIC MEASUREMENTS
1. Length – 50 cm / 20 inches; 19-21.5 inches/ 47.5-
W. MINOR SYMPTOMS OF PREGNANCY 53.75 cm
1. Nausea and vomiting (increase glucose intake, dry 2. Head circumference – 33-35 cm
crackers) 3. Chest circumference – 31-33 cm
2. Pyrosis (small feedings, don’t lie down p.c.) 4. Abdominal circumference – 31-33 cm
3. Constipation (increase roughage)
4. Fatigue (increase rest and sleep; good resting D. SPECIFIC NURSING ACTIONS
position) 1. Oil bath
5. Varicosities (sims position; raise legs for 15-20 2. Cord dressings
minutes) 3. Crede’s prophylaxis
6. Muscle cramps 4. Vitamin K administration
7. Hemorrhoids (sims; knee-chest) 5. Weighing
8. Palpitations ( refrain sudden, rapid movements) 6. Feeding
9. Leukorrhea (daily bath)
10. Pruritus (referred to MD) E. PHYSIOLOGIC WEIGHT LOSS
11. Frequency of urination

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 1. No longer under the influence of maternal 3. Colic
hormones 4. Spitting up
2. Voids and passes out stools 5. Skin irritation
3. Has limited intake 6. Occasional “crossed eyes”
4. Has beginning difficulty establishing suckling 7. Seborrheic dermatitis (cradle cap)

F. VITAL SIGNS
1. Pulse – 120-160 bpm
2. Respirations - 30-60 bpm
3. BP – 80/46 – 100/50 mm Hg

G. SKIN
1. Acrocyanosis
2. Pallor
3. Gray color
4. Jaundice
5. Harlequin sign
6. Mongolian spots
7. Lanugo
8. Desquamation
9. Petechiae
10. Milia

H. FETAL ACCESSORY STRUCTURES

1. Foramen ovale
2. Ductus Arteriosus  ligamentum arteriosum
3. Ductus Venosus  ligamentum venosum
4. Umbilical vein
5. Umbilical arteries

I. REFLEXES
1. Blink
2. Rooting
3. Sucking
4. Extrusion
5. Swallowing
6. Tonic-neck
7. Babinski
8. Landau
9. Palmar/Plantar grasp/ step in place
10. Moro

J. BREAST MILK
1. low in proteins (lactalbumin)
2. high CHO (easily digestible lactose)
3. low minerals
4. low fat
5. energy value = 20 cal/oz

K. COW’S MILK
1. high CHON (casein)
2. high fat (linoleic)
3. low CHO
4. high minerals
5. energy value – 20 cal/oz

L. COMMON HEALTH PROBLEMS

1. Constipation
2. Loose stools