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OBSTETRICS > 1M - Parturition > Flashcards

1M - Parturition Flashcards

1
Q

Clinical labor is what phase of parturition?

A

Phase 3

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2
Q

This is the quiescence stage of parturition?

A

Phase 1

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3
Q

This is the phase of parturition where contractile unresponsiveness and cervical softening are manifested?

A

Phase 1

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4
Q

This phase of parturition involves the uterine preparation for labor, cervical ripening and formation of the lower uterine segment?

A

Phase 2

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5
Q

What are the stages of labor?

A

Contraction, cervical dilation and fetal and placental expulsion

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6
Q

This phase of parturition involves the involution of the uterus, cervical repair and breastfeeding?

A

Phase 4

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7
Q

This phase of parturition can be called the phase of parturient recovery?

A

Phase 4

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8
Q

What do you call the low intensity myometrial contractions that are felt during the quiescent stage and this normally do not cause cervical dilation?

A

Braxton Hicks contractions or false labor

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9
Q

To maintain quiescence, prostaglandins are are markedly increased? T or F?

A

False

They are suppressed

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10
Q

What genetic defects can cause cervical insufficiency during pregnancy?

A

Ehler Danlos Syndrome and Marfan syndrome

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11
Q

This phase of parturition may also be called the phase of uterine awakening or activation?

A

Phase 2

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12
Q

When does phase 2 of parturition start?

A

Last few weeks of pregnancy

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13
Q

How long does the Phase 1 of parturition last?

A

Start of pregnancy until near the end of pregnancy

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14
Q

Phase 2 of parturition happens because of the withdrawal of what hormone?

A

Progesterone

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15
Q

This phase of of parturition involves the formation of the lower uterine segment and the descent of the fetus to or through the pelvic inlet?

A

Phase 2

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16
Q

Oxytocin receptors level rise during phase 2 of parturition, what are the primary regulators of oxytocin receptor expression?

A

Estrogen and progesterone

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17
Q

This hormone maintains uterine quiescence through inhibition of myometrial oxytocin response?

A

Progesterone

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18
Q

This substance is largely responsible for the structural disposition of the cervix?

A

Collagen

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19
Q

Production of these substances during cervical ripening is thought to increase viscoelasticity, hydration and matrix disorganization?

A

Glycosaminoglycans and proteoglycans

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20
Q

Inflammatory substances are increased during stage 2 of parturition. T or F?

A

True

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21
Q

Therapies to prevent cervical ripening are present? T or F?

A

False

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22
Q

What are the fetal contributions to parturition?

A

Fetal stretch, Fetal endocrine cascades, Surface Protein A

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23
Q

This fetal substance from the placenta and decidua is required for lung maturation of the fetus?

A

Surface Protein A

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24
Q

Before 37 weeks of gestation, and before lightening, what organs does the uterus compress into?

A

Lungs and diaphragm

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25
Q

After 37 weeks, or after lightening, what organs are compressed by the fetus?

A

Bladder and cervix

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26
Q

What are the characteristics of true labor?

A

Contraction, Cervix, Fetus

Contractions are regular, increased in intensity and duration when walking, felt along the lower back to the abdomen

Bloody show
Dilation and effacement of the cervix

fetus is engaged

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27
Q

What are the characteristics of false labor?

A

Contraction, Cervix and Fetus

Irregular contractions - braxton hicks contractions

Cervix is unchanged

fetus is ballotable

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28
Q

Stage 1 of labor is the dilatation of the cervix from?

A

0 - 10 cm

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29
Q

This stage of labor starts from complete dilatation to the effacement and delivery of the fetus?

A

Stage 2

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30
Q

This stage of labor starts from the delivery of the baby to the delivery of the placenta?

A

Stage 3

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31
Q

This stage of labor happens at the first hour after delivery?

A

Stage 4

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32
Q

This process begins with the onset of regular uterine contractions and ends with delivery of the newborn and expulsion of the placenta

A

Labor

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33
Q

What are important fetal factors to be considered by the mechanism of labor?

A

Fetal lie, fetal presentation, fetal attitude or posture, fetal position

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34
Q

This relation of the fetal axis to that of the mother?

A

Fetal Lie

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35
Q

What is the fetal lie in more than 99% of labors at term?

A

Longitudinal lie

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36
Q

Transverse lie predisposes the mother and fetus to what conditions?

A

Hydramnios. Placenta previa, uterine anomalies

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37
Q

If the fetal and maternal axis crosses at a 45 degree angle, what is the fetal lie?

A

Oblique lie

38
Q

This is defined by the presenting part of the fetal body that is in closest proximity to the birth canal?

A

Fetal presentation

Either cephalic or breech for longitudinal

shoulder for transverse

39
Q

What is the fetal presentation if the presenting part is the occipital fontanel?

A

vertex or occiput presentation

40
Q

If the neck is only partly flexed what is the presenting part and the fetal presentation?

A

anterior fontanel; sinciput presentation

41
Q

If the fetal neck is partially extended, what is the fetal presentation?

A

Brow Presentation

42
Q

If the fetus has its neck sharply extended, what is the fetal presentation?

A

face presentation

43
Q

Sinciput and brow presentation can convert to vertex or face presentation as labor progresses? T or F?

44
Q

Failure of the fetal presentation to convert to vertex or face presentation can result to what condition?

45
Q

Describe Frank Breech presentation?

A

Hips are flexed and thighs are extended

46
Q

Describe complete breech presentation?

A

Both the hips and thighs are flexed

47
Q

Describe footling breech?

A

At least one foot presents below the pelvis

48
Q

This is defined as a characteristic posture that the fetus assumes in the later months of pregnancy?

A

Fetal attitude or posture

49
Q

What is the common fetal attitude?

50
Q

If the fetal attitude is well flexed, what is it called?

A

Suboccipitobregmantic - 9.5 cm

51
Q

If the fetal attitude is less well flexed or deflexed, what is it called?

A

occipitofrontal - 11.5cm

52
Q

If the fetal presentation is brow presentation, what is the fetal attitude?

A

Occipitomental (extended fetal attitude) - 13 cm

53
Q

If the fetal attitude is hyperextended, what is the fetal presentation?

A

Face presentation

Fetal attitude is called submentobregmatic - 9.5 cm

54
Q

This refers to the relationship of an arbitrary chosen portion of the presenting part to the right or left of the birth canal?

A

fetal Position

55
Q

What Leopold’s maneuver identifies which fetal pole occupies the fundus? (fetal presentation)

A

LM 1 (if breech or cephalic)

56
Q

Which Leopold’s Maneuver determines the fetal lie?

A

LM2 (Longitudinal, transverse or oblique)

57
Q

Which Leopold’s maneuver checks whether the fetus is already engaged or not?

58
Q

What Leopold’s Maneuver checks for the fetal position?

A

LM 4 (LOT, ROA, etc)

59
Q

Enumerate the cardinal movements of labor in order?

A

Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

60
Q

This is the mechanism in whihc the biparietal diameter passes through the pelvic inlet?

A

Engagement

61
Q

This is the first requisite of birth?

62
Q

In nulliparas, descent happpens together with engagement? True or false?

A

False, it is in multiparas

In nulliparas, engagement may happen before labor and further descent may not follow until onset of second stage of labor

63
Q

This cardinal movement is the change from suboccipitobregmatiic to the longer occipitofrontal diameter?

64
Q

Movement of the head in such a manner that the occiput gradually moves toward the symphysis pubis anteriorly or less commonly posteriorly towards the sacrum

A

Internal Rotation

65
Q

This cardinal movement brings the base of the occiput into direct contact with the inferior margin of he symphysis pubis?

66
Q

This cardinal movement of labor takes place when the head reaches the vulva.

67
Q

This cardinal movement is also called restitution which returns the head into the oblique position and completion towards transverse position of the shoulders.

A

External rotation

68
Q

This cardinal movement of labor brings the bisacromial diameter of teh fetus in relation to the AP diameter of the pelvic outlet

A

External Rotation

69
Q

This cardinal movement of labor happens immediately after external rotation?

A

Explulsion

70
Q

This is defined by uterine contractions that bring about effacement and dilatation of the cervix?

71
Q

This division of the first stage of labor is characterized by little dilatation and cervical connective tissue changes?

A

Preparatory division

72
Q

This division of the first stage of labor is also called the latent phase?

A

Preparatory division

73
Q

What measurement of cervical dilatation indicates the start of active labor?

74
Q

This division of the 1st stage of labor is affected by anesthesia?

A

Preparatory division

75
Q

This division of 1st stage of labor is characterized by rapid dilatation and is unaffected by sedation or anesthesia?

A

Dilatational division

76
Q

What is prolonged latent phase?

A

Multiparas - 14 hrs

Nulliparas - 20 hrs

77
Q

This division of 1st stage of labor is called the deceleration phase of cervical dilatation?

A

Pelvic Division

78
Q

This division of 1st stage of labor is where cardinal movement of labor begins?

A

Pelvic division

79
Q

This stage of labor starts with complete cervical dilatation and ends with fetal delivery?

80
Q

What are indications of labor?

A

Uterine contractions 5 minutes apart for 1 hour and cervical dilatation of more than 4 cm

81
Q

What bishop score is favorable for labor induction or augmentation?

A

Bishop score of 8

Review bishop scoring

82
Q

When can we say that the cervix is fully dilated?

83
Q

Intrapartum fetal heart rate monitoring for normal OB patient interval?

A

Every 30 minutes for 1st stage and every 15 minutes for 2nd stage

84
Q

Intrapartum fetal heart rate monitoring for high risk pregnnacy?

A

Every 15 minutes for 1st stage and every 5 minutes for 2nd stage

85
Q

Interval for cervical examination during the first stage of labor?

A

Ever 2-3 hrs

86
Q

Food can be freely taken during the active stage of labor and delivery? T or F?

87
Q

What position is most likely comfortable for the woman in labor?

A

Lateral recumbent

88
Q

What position is typically avoided to avert aortocaval compression?

89
Q

This degree of laceration involves only the vaginal epithelium or the perineal skin?

A

1st degree

90
Q

Degree of laceration that involves the perineal muscles (bulbospongiosus and superficial transverse perineal msuscles) but spares the anal sphincter complex

A

2nd degree

91
Q

What is involved in 3A 3rd degree laceration?

A

< 50% of the external anal sphincter

3B is >50% of the external anal sphincter

92
Q

What is involved in the 4th degree laceration?

A

Perineal body, entire anal sphincter complex and anorectal mucosa

OBSTETRICS (36 decks)

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