Positive findings strong predictor of preterm labor

Positive findings = strong predictor of preterm labor or rupture of the
membranes w/in 2 weeks of positive test
o
fFN levels are measured with an enzyme immunoassay
o
fFN is present the first half of pregnancy
o
Is NOT present after 20 weeks
o
Is found in amniotic fluid (possible ROM)
o
Is present again near term
o
Found in cervical area (swab) as well as amniotic fluid (AF)
o
Because sexual intercourse within the previous 24 hrs, vaginal creams, and recent
vaginal exams can cause false findings, they should be avoided prior to a fetal fibronectin
(fFN) test.
 Percutaneous Umbilical Blood Sampling (PUBS) or Cordocentesis—obtain blood from umbilical
cord
o
helps Dx blood disorders (hemophilias, hemoglobinopathies) and incompatibilities, fetal
infections, chromosomes abnormalities, non-immune hydrops, and isoimmune
hemolytic disorders.
o
Risks: bleeding from sampling site, premature ROM, chorioamnionitis, and fetal
bradycardia
Chapter 22
Critical Factors in Labor=4 TQ
 Birth Passageway (R/T type of pelvis)
o
Gynecoid (50%) : “female pelvis” and Anthropoid—favorable to vaginal birth
o
Android (20%) “male pelvis” and platypelloid pelvises—not favorable to vaginal birth;
difficult labor

 Birth passenger (Fetus)
o
Fetal attitude—refers to the relation of the fetal body parts to one another; posture the
fetus assumes as it conforms to the shape of the uterine cavity (usually a flexed position)
o
Fetal lie—the relationship of the long, or cephalocaudal axis (spinal column) of the fetus
to the long, or cephalocaudal axis of the mother
– Longitudinal=vertical lie cephalocaudal axis of mother and baby are parallel;
transverse=horizontal lie; axis are perpendicular
o
Fetal presentation—determine by fetal lie and refers to the body part of the fetus that
enter the maternal pelvis first and leads through the birth canal during labor
– Presenting part=portion of the fetus that is felt through the cervix on vaginal
exam
– Cephalic: head first; four types/presenting part: vertex=occiput;
sinciput=occipitofrontal diameter; brow=occipitomental diameter; face:
submentobregmatic diameter
– Breech: lower extremities or buttocks
 Breech=complete=baby sitting Indian style; footling breech position=one
foot is trying to come down; frank breech=legs are up and butt is down;
Can be delivered vaginally, but more dangerous
– Shoulder
 Relationship of Maternal Pelvis and Presenting Part
o
Engagement—occurs when the largest diameter of presenting part reaches or passes
through the pelvic inlet; ex. In cephalic presentation, the biparietal diameter is the
largest dimension to pass through the pelvic inlet; ; at zero station the baby is engaged
o
Station—refers to the relationship of the presenting part of an imaginary line drawn
between the ischial spines of the maternal pelvis; ; in a normal pelvis the ischial spines
mark the narrowest diameter through which the fetus must pass
– Negative number=presenting part is above the ischial spines
–