1F - Vaginal Delivery

Question 1

What is early active phase of cervical dilatation?

Answer 1

4-5 cm

Question 2

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

Answer 2

Pelvic Division

Covers the cardinal movements of labor.

Question 3

What dilatation is the phase of maximum slope?

Answer 3

6 - 8 cm

Question 4

Friedmans’s curve shows what shape?

Answer 4

Sigmoid - this is used

Zhang - exponential staircase

WHO - diagonal straight

Question 5

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

Answer 5

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

Question 6

What is the purpose of Zhang and Friedmans curve?

Answer 6

Friedman - to define normal progress

Zhang - to prevent CS

Question 7

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

Answer 7

12 hours for nullipara and 10 hours for multipara

Question 8

Labour guide vs WHO modified partograph active phase?

Answer 8

Labour guide - 5-10 cm

WHO - 4-10

Question 9

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

Answer 9

WHO labor guide

Question 10

When are fetal heart tone best heard?

Answer 10

After contractions or 1-2 mins before peak of contractions

Question 11

Frequency of monitoring for low risk patients?

Answer 11

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

Question 12

Frequency of monitoring for high risk patients?

Answer 12

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

Question 13

What happens in lithotomy position anatomically?

Answer 13

Gliding of sacroililac joints causing widening of pelvic outlet

*Gaskin Maneuver - Racing position while lying down

Question 14

How much of an increase does lithotomy position have?

Answer 14

1.5 - 2cm

Question 15

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

Answer 15

McRoberts Maneuver

Question 16

What is the shortest diameter of the fetal head?

Answer 16

Subocciitobregmatic - 9.5cm

Question 17

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

Answer 17

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

PSILESSS

Question 18

When do we do episiotomy?

Answer 18

After seeing internal rotation - crowning

Question 19

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.

Answer 19

Episiotomy

Question 20

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

Answer 20

Ritgen’s Maneuver

Question 21

What is the indicated episiotomy for short prerineum?

Answer 21

Mediolateral episiotomy

Question 22

What are the disadvantages of median episiotomy?

Answer 22

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

Question 23

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

Answer 23

Medial episiotomy

Question 24

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

Answer 24

Macrosomia or large sized baby

Question 25

What traction is applied on the delivery of the shoulders?

Answer 25

Downward upward traction Down for anterior shoulder Up for posterior shoulder

Question 26

Timing of cord clamping and reason?

Answer 26

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

Question 27

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

Answer 27

1st clamp - 2 cm 2nd clamp - 3 cm from first clamp

Question 28

What it the third stage of labor?

Answer 28

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

Question 29

This is the first sign of placental separation?

Answer 29

change from discoid to globular shaped uterus

Question 30

What type of placental separation is dirty and bloody separation?

Answer 30

Duncan

Question 31

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

Answer 31

Duncan

Question 32

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

Answer 32

Schultze

Question 33

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

Answer 33

Schultze

Question 34

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

Answer 34

Fundal massage

Question 35

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

Answer 35

Uterotonics (Oxytocin)

Question 36

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

Answer 36

Controlled cord traction

Question 37

What is the synthetic long acting oxytocin like drug?

Answer 37

Carbetocin

Question 38

What is the synthetic PGE1 analog?

Answer 38

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

Question 39

What is the available synthetic PGF2 alpha agonist?

Answer 39

Carboprost

Question 40

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

Answer 40

Ergometrine

Question 41

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

Answer 41

1-4 hours post placental delivery

Question 42

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

Answer 42

15 mins for 1 hours

Question 43

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

Answer 43

Fetal

Question 44

What are always checked upon delivery of the placenta?

Answer 44

Cotyledons, vein and arteries and