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OBSTETRICS > 1F - Vaginal Delivery > Flashcards

1F - Vaginal Delivery Flashcards

1
Q

What is early active phase of cervical dilatation?

A

4-5 cm

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2
Q

This division of labor covers the deceleration phase up to the second stage of labor

A

Pelvic Division

Covers the cardinal movements of labor.

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3
Q

What dilatation is the phase of maximum slope?

A

6 - 8 cm

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4
Q

Friedmans’s curve shows what shape?

A

Sigmoid - this is used

Zhang - exponential staircase

WHO - diagonal straight

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5
Q

According to friedman, after reaching 4 cm, the acceleration of dilatation is at a rate of?

A

1.2 cm/hr for nullipara and 1.5cm/hr for multipara

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6
Q

What is the purpose of Zhang and Friedmans curve?

A

Friedman - to define normal progress

Zhang - to prevent CS

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7
Q

Women are in prolonged active phase of labor when they exceed how many hours?

A

12 hours for nullipara and 10 hours for multipara

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8
Q

Labour guide vs WHO modified partograph active phase?

A

Labour guide - 5-10 cm

WHO - 4-10

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9
Q

What facilitates the implementation of the WHO intrapartum care recommnedation and model of care?

A

WHO labor guide

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10
Q

When are fetal heart tone best heard?

A

After contractions or 1-2 mins before peak of contractions

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11
Q

Frequency of monitoring for low risk patients?

A

Every 30 for first stage of labor and every 15 for 2nd stage of labor

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12
Q

Frequency of monitoring for high risk patients?

A

Every 15 for 1st stage of labor and every 5 mins for 2nd stage of labor

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13
Q

What happens in lithotomy position anatomically?

A

Gliding of sacroililac joints causing widening of pelvic outlet

*Gaskin Maneuver - Racing position while lying down

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14
Q

How much of an increase does lithotomy position have?

A

1.5 - 2cm

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15
Q

What is the hyperflexion of the thigh to widen functional capacity of the pelvis?

A

McRoberts Maneuver

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16
Q

What is the shortest diameter of the fetal head?

A

Subocciitobregmatic - 9.5cm

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17
Q

From within outward what are the tissues of the pelvic floor?

A

peritoneum - subperiotneal connective tissue - internal pelvic fascia - levator ani and coccygeus muscles - external pelvic fascia - superficial muscles and fascia - subcutaneous tissue - skin

PSILESSS

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18
Q

When do we do episiotomy?

A

After seeing internal rotation - crowning

19
Q

This is a surgical incision on the mother’s perineum performed as the baby’s head emerges from the vaginal canal during birth intended to prevent perineal tears of the perineal muscles.

A

Episiotomy

20
Q

What is the most important maneuver done during crowning which requires putting pressure at the perineum and supporting the fetal head?

A

Ritgen’s Maneuver

21
Q

What is the indicated episiotomy for short prerineum?

A

Mediolateral episiotomy

22
Q

What are the disadvantages of median episiotomy?

A

Prone to 3rd and 4th degree lacerations and higher rates of anal sphincter and rectal injury

23
Q

Which heals better, is easier to repair and has les blood loss? Medial or mediolateral episiotomy?

A

Medial episiotomy

24
Q

Medial episiotomy is good for patients with wide peritoneum but is bad for what condition of the baby?

A

Macrosomia or large sized baby

25
Q

What traction is applied on the delivery of the shoulders?

A

Downward upward traction

Down for anterior shoulder
Up for posterior shoulder

26
Q

Timing of cord clamping and reason?

A

Delayed for 3 minutes; for transfer of blood (30cc) and iron (50mg)

27
Q

How many cm from the baby’s abdomen will the clamp be placed?

A

1st clamp - 2 cm

2nd clamp - 3 cm from first clamp

28
Q

What it the third stage of labor?

A

From the delivery of the fetus to the delivery of the placenta

29
Q

This is the first sign of placental separation?

A

change from discoid to globular shaped uterus

30
Q

What type of placental separation is dirty and bloody separation?

A

Duncan

31
Q

If placental separation is at the periphery, what type of separation is this?

A

Duncan

32
Q

If the separation is clean and shiny without a sudden gush of blood?

A

Schultze

33
Q

If the placental separation is central, what is the type?

A

Schultze

34
Q

If there is no contraction after delivery of the fetus, what non pharmacological management can be safely done first?

A

Fundal massage

35
Q

What is the most important part of the active management of third stage of labor?

A

Uterotonics (Oxytocin)

36
Q

What management in the 3rd stage of labor prevents uterine inversion?

A

Controlled cord traction

37
Q

What is the synthetic long acting oxytocin like drug?

A

Carbetocin

38
Q

What is the synthetic PGE1 analog?

A

Misoprostol

Inhibits gastric acid and pepsin secretion and enhances mucosal resistance to injury

39
Q

What is the available synthetic PGF2 alpha agonist?

A

Carboprost

40
Q

What is the ergot alkaloid that increases uterine muscle tone by causing sustained uterine contractions

A

Ergometrine

41
Q

What is the most crucial time in the 4th stage of labor?

A

1-4 hours post placental delivery

42
Q

At the 4th stage of labor, vital signs are checked every?

A

15 mins for 1 hours

43
Q

The shiny side of the placenta is the maternal or fetal side?

A

Fetal

44
Q

What are always checked upon delivery of the placenta?

A

Cotyledons, vein and arteries and

OBSTETRICS (36 decks)

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