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OB 1 > 2.5A Conduct of Labor and Delivery > Flashcards

2.5A Conduct of Labor and Delivery Flashcards

lecturer: Dr. Alicia Bautista

1
Q

what is the most common EDC?

A

38-42 WEEKS

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2
Q

What is the intervals of a true labor

A

5-10 mins in durations

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3
Q

does interval shorten or lengthen in true labor?

A

shorten

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4
Q

where is the location of the discomfort during true labor

A

back and hypogastric area in abdomen, some may have no discomfort

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5
Q

what is the most important determinant of true labor

A

cervical dilation

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6
Q

how do you describe uterine contractions? (3)

A

frequency, duration, intensity

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7
Q

when should the FHR be taken?

A

end of contractions

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8
Q

can you hear the FHR during contractions

A

no

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9
Q

what is the normal FHR?

A

110-160

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10
Q

What are the things you check during vaginal exam? (ACPSP)

A
  1. Amniotic fluid
  2. cervix status
  3. presenting part
  4. station
  5. pelvic architecture
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11
Q

what is assessed during the speculum exam?

A

amniotic fluid

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12
Q

if the presenting part is not fixed in the pelvis, there is great possibility of _______ leading to fetal distress and death

A

umbilical cord prolapse and compression

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13
Q

what is the pH of amniotic fluid

A

7-7.5 (alkaline), check this if you are not sure if there is ruptured membrane

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14
Q

what is the color and purpose of nitrazine test

A

used to check pH to determine if its amniotic fluid or vaginal pH (amniotic fluid is 7, vaginal pH is acidic).
a positive nitrazine test is blue, or positive

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15
Q

what is the pattern of the amniotic fluid called

A

fern like pattern or arborization

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16
Q

what are 4 parameters assessed during cervical exam? (sdcc)

A

softness, degree of effacement, cervical dilation, cervical position

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17
Q

what are the 3 ways to describe softness of the cervix?

A

soft, firm, intermediate

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18
Q

this refers to the obliteration or the thinness of the cervix

A

degree of effacement

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19
Q

when the cervix is paper thin, it is said to be ___ effaced

A

100%

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20
Q

what is the normal length of the cervical canal?

A

2 cm

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21
Q

when the cervix is 25% effaced, you can insert _ fingers

A

2

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22
Q

effacement: 2 fingers is equal to 3.5 cm or __ effaced

A

50%

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23
Q

estimates the ave. diameter of the original opening

A

cervical dilation

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24
Q

dilation occurs simultaneously with

A

effacement

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25
Q

what is the diameter of a fully dilated cervical opening

A

10cm

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26
Q

used to predict labor induction outcome

A

bishop’s score

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27
Q

the duration of the labor is ___ correlated to the bishops score

A

inverse

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28
Q

a Bishop score of 8 is

A

likely to achieve a successful vaginal birth

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29
Q

a Bishop score of _ requires cervical ripening

A

6

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30
Q

what are the 5 components of the bishop score

A

dilation, effacement, consistency, position, fetal station

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31
Q

this is an imp. indicator of the 1st stage of labor progression

A

cervical dilation

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32
Q

the cervical position becomes ________ (closer to vagina) as labor comes close

A

more anterior

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33
Q

describes the fetal head in relation to the ischial spines

A

fetal station

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34
Q

if the fetal station is negative , the head is

A

further inside than the ischial spines

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35
Q

presenting part may be described as either (2)

A

breech or cephalic

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36
Q

lowermost portion of the presenting part AT THE LEVEL of the ischial spines is said to be at

A

station 0

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37
Q

what is the goal of the EINC protocol by 2015?

A

decrease maternal mortality

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38
Q

the first stage of labor is from ____ to ____

A

regular uterine contractions to full cervical dilation (10cm)

39
Q

nulliparous mothers often take ___ hrs during the 1st stage of labor

A

7 hours

40
Q

3 signals of the first stage of labor

A

water breaking, bloody show, contraction

41
Q

check the fht every _ mins if no prob during the first stage

A

30

42
Q

check the fht every _ mins if no prob during the 2nd stage

A

15

43
Q

process to minimize fecal contamination

A

enema

44
Q

is enema and perineal shaving indicated

A

no

45
Q

do you encourage the parturient to move if she has no complications

A

yes, let her be comfy

46
Q

vaccine given within 24 hours

A

Hepa B

47
Q

Used to augment labor when there is immediate access to caesarian section

A

Oxytocin

48
Q

when should u give IM Oxytocin

A

after birth, to stop bleeding, titrated

49
Q

said to shorten 2nd labor stage in primis

A

amniotomy (open the bag)

50
Q

maternal vitals should be checked every

A

4 hours, if normal

51
Q

if membrane is ruptured early, check the temp,

A

every hour.

52
Q

periodic vaginal exam should be

A

2-3 hours

53
Q

should food be withheld

A

yes, to prevent aspiration, exception is ice chips.

54
Q

period of 2nd stage is from ____ to ____

A

full dilation to delivery

55
Q

duration of 2nd stage is ___ for nullipara

A

50 mins

56
Q

duration of 2nd stage is ___ for multipara

A

20 mins

57
Q

delivery: patient is in ___ Position

A

lithotomy

58
Q

do not spread legs to wide to avoid

A

4th degree episiotomy

59
Q

encirclement of the largest head diameter by the vulvar ring

A

crowning

60
Q

when is episiotomy performed

A

head circumference is visible during a contraction with a diameter of 3 to 4cm

61
Q

disadv. of a mediolateral episiotomy

A

rectal orifice can be cut

62
Q

only advantage of a mediolateral episiotomy

A

extension thru the anal sphincter and rectum

63
Q

allows controlled delivery of the head when vaginal introitus is less than 5 cm

A

ritgens maneuver

64
Q

anterior shoulder should be pushed ____, then the posterior shoulder pushed ____

A

pushed down, pushed up

65
Q

non separation of mom and baby should be strictly

A

90 mins

66
Q

3 steps of EINC

A

Thorough and immediate drying, early ssc, mom and baby rooming in

67
Q

immediate and thorough drying is time bound by

A

30 seconds

68
Q

early ssc should be done

A

after 30 seconds

69
Q

properly timed cord clamping time bound

A

1-3 minutes

70
Q

position of clamps

A

2 cm, 5 cm, cut in between

71
Q

when do you cut the cord

A

when the pulsations stop/1-2 minutes

72
Q

what do u add to the umbilical stump

A

nothing

73
Q

duration of the 3rd stage of labor

A

delivery of baby to the delivery of the placenta

74
Q

2 types of management for the 3rd stage of labor

A

expectant physiological management, active management

75
Q

pulling on the placenta can cause

A

placental inversion

76
Q

signs of placental separation

A

gushing of blood, globular and firmer fundus (calkins sign), umbilical cord lengthening

77
Q

what is the calkin’s sign

A

globular and firmer fundus

78
Q

during AMTSL, how much oxytocin is givem

A

10 mg IM

79
Q

2 mechanisms of placental separation

A

duncan’s and schultze

80
Q

maternal side and cotyledons appear first in this mechanism of placental separation

A

duncan (dugo, dirty)

81
Q

fetal side is first delivered during placental separation, termed as

A

Schultze (shiny)

82
Q

AMTSL is time bound by _

A

90 minutes

83
Q

manuever for placental delivery by applying pressure to the suprapubic area

A

Brandt Andrews

84
Q

4th stage of labor is

A

an hour after placental delivery

85
Q

during the 4th stage of labor: check for

A

uterine atony, lacerations, abnormal bleeding

86
Q

maternal heart rate is highest during

A

postpartum (walang pupuntahan yung blood)

87
Q

fourchette - vaginal mucosa is lacerated, but not including the fascia and the muscle. including the periurethral area

A

1st degree

88
Q

2nd degree of laceration includes

A

up to the fascia and muscle of the perineal body

89
Q

3rd degree of laceration …

A

up to the anal sphincter

90
Q

risk of 3rd degree of laceration

A

fecal incontinence

91
Q

4th degree

A

up to rectal MUCOSA

92
Q

Risk of 4th degree

A

fistula

93
Q

episiorrhapy: suture ___ above the laceration point`

A

1cm

94
Q

in 4th degree: suture should

A

go through the rectum

OB 1 (3 decks)

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