labor

Clinical manifestations

• lightening occurs when the baby drops or settles lower in the pelvis
  • dyspnea may lessen because the lungs have more room to expand
  • increased pressure in the pelvis
  • urinary frequency may increase
  • usually occurs several weeks prior to first delivery
  • in subsequent births, it may happen hours before delivery
• bloody show
  • as the cervix thins & starts to dilate, small capillaries burst & cause a small quantity of pink or brown vaginal discharge
    • vaginal bleeding is abnormal
  • the mucous plug, which has sealed the cervix throughout pregnancy, dislodges
  • can occur anywhere from hours to several weeks before delivery
• nesting instinct
  • some women notice a burst of energy a few days prior to going into labor
• nausea & diarrhea
• abdominal cramping
• increased Braxton Hicks contractions

Management

• epidural analgesia associated with 35% lower severe maternal morbidity
  • most pronounced among women with risk factors* or preterm delivery

* risk factors for severe maternal morbidity

• preexisting severe cardiac disease or respiratory disease, preeclampsia, multifetal gestation, morbid obesity (BMI > 40), previous caesarian section, or breech presentation

More general terms

• physiologic process

More specific terms

• labor & delivery
• premature labor; preterm labor
• rupture of membranes

Additional terms

• induction of labor