Abnormal Labor Flashcards

1
Q

Protracted active phase dilatation is when the mother has regular contractions and the rate of cervical dilation is

A

<1.2cm/hr: Nulli

<1.5cm/hr: Multi

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2
Q

A diagnosis of arrest disorder can be made when the mother is in active phase with at least how much cervical dilation?

A

3-4cm

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3
Q

Criteria for arrest of 2nd stage of labor is how many hours with and without epidural?

A

>4 hours no progress with epid >3 hours no progress without epid

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4
Q

Prolonged latent phase in an nulli and multigravid (0-3cm)

A

>20 hours in nulli >14 hours in multi

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5
Q

Intervention for prolonged latent phase

A

Bed rest Oxytocin

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6
Q

Prolonged deceleration phase (8-10cm) is how many hours in a nulli and multigravid?

A

>3 hours nulli >1 hour multi

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7
Q

Secondary arrest in dilatation (max slope) occurs after

A

>2 hours

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8
Q

Arrest of descent happens if the fetus is in what level for more than 1 hour?

A

Station +1 onwards

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9
Q

Criteria for arrest disorder: Beyond latent phase Uterine contraction >200 Montevideo units for ___ hours without cervical change

A

2 hours

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10
Q

CONSIDER CS, IF WITH:

  • ______ of uterine contractions of >200 MVU without cervical change
  • ______ of oxytocin augmentation for inadequate contractions
A

4 hours

6 hours

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11
Q

This describes the number of contractions x average uterine pressure in a 10 min strip

A

Montevideo unit

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12
Q

Inappropriate leg positioning in stirrups in prolonged second stage may be die to compression of what nerve?

A

Common peroneal nerve

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13
Q

Zavanelli maneuver requires restoring the fetal head back into this position

A

Occiput anterior or posterior

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14
Q

Shoulder dystocia happens when the anterior shoulder becomes wedged behind this structure in the pelvis

A

Symphysis pubis

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15
Q

Head to body delivery time of more than ____ seconds indicates shoulder dystocia

A

>60 seconds

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16
Q

Lifting the legs in McRobert’s maneuver increases

A

AP diameter

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17
Q

This maneuver attemps anterior shoulder disimpaction by applying suprapubic pressure over posterior aspect of anterior shoulder

A

Mazzanti

18
Q

This maneuver attemps anterior shoulder disimpaction by inserting 2 fingers vaginally and pushing the posterior shoulder toward the chest

A

Rubin

19
Q

This maneuver puts 2 fingers on the anterior aspect of the posterior shoulder to rotate obliquely

A

Wood corkscrew

20
Q

This maneuver puts patient into all fours, grasp posterior arm of the fetus, sweeps against chest and deliver

A

Gaskin

21
Q

Which maneuver is applied to reduce the nuchal arm in breech delivery

A

Loveset maneuver

22
Q

This maneuver in breech delivery is where the assistant applies suprapubic pressure to favor flexion and engagement of fetal head

A

Mauriceau-Smellie-Veit maneuver

23
Q

Intervals shorter than how many months between pregnancies have been associated with an increased risk for preterm birth?

A

18 months

24
Q

One of the most common causes for indicated preterm birth

A

Placenta previa

25
Q

Indomethacin as tocolytic promotes this effect on the fetus

A

Premature closure of the ductus arteriosus

26
Q

Neonate that has the function expected of a newborn at <37 weeks with underdeveloped organ functions

A

Premature

27
Q

One of the contributing factors to preterm birth is a threatened abortion during this period

A

6-13 weeks AOG

28
Q

Intervals LONGER than how many months between pregnancies have been associated with an increased risk for preterm birth?

A

59 months

29
Q

Infection usually associated with preterm birth

A

Bacterial vaginosis

30
Q

Single most powerful predictor of preterm birth

A

Transvaginal sonogram

31
Q

One of the sonographic signs of preterm birth is shortening of cervix to less than 25mm at how many weeks AOG?

A

16-24 weeks

32
Q

Loading dose of magnesium sulfate for preterm labor

A

4g slow IV push over 20 mins

33
Q

Antidote for Magnesium Sulfate toxicity

A

Calcium gluconate

34
Q

Tocolytic agent of choice for preterm birth

A

Nifedipine 10mg Q6

35
Q

Prophylactic cerclage is done during

A

10-12 weeks AOG

36
Q

Corticosteroid can also be given for preterm birth during

A

24-34 weeks AOG

37
Q

Only reliable indicator for chorioamnionitis

A

Maternal fever

38
Q

Criteria for chorioamnionitis include maternal fever plus one of the ff

A

Fetal tachycardia Uterine tenderness Purulent or foul smelling discharg Incresed ESR Leukocytosis

39
Q

Management of chorioamnionitis

A
  • Seven (7) day regimen:
    • First 48 hours: Ampicillin 2 grams/IV q6, Erythromycin 250 mg q6
    • After 48 hours: Oral amoxicillin 250 mg q8, Erythromycin 250 mg q8
  • Three (3) day regimen:
    • Ampicillin or Ampicillin-Sulbactam
    • Ampicillin IV q6 and Gentamicin q8 until delivery
    • Clindamycin or Metronidazole q8 added for anaerobic coverage

*Amoxicillin-clavulanate not recommended due to the increased incidence of NEC.

40
Q

Birth must be delayed for this amount of time after initiation of corticosteroid therapy to reduce rates of respiratory distress

A

24 hours after last dose

41
Q

Reversible complication of indomethacin

A

Oligohydramnios

42
Q

Administration of magsul to preterm birth can reduce rates of which neonatal outcome?

A

Cerebral palsy