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Patho OB > Abnormal Labor > Flashcards

Abnormal Labor Flashcards

1
Q

question

A

answer

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2
Q

which of the following characterizes hypnotic uterine dysfunction?

a. Highest pressure gradient is over the midzone
b. Treatment is sedation
c. No basal hypertonus
d. Asynchronous uterine pressure gradient

A

c. No basal hypertonus

. More common
. Synchronous
. Treatment is oxytonin

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3
Q

What is the treatment for hypotonic uterine dysfunction?

A

oxytonin

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4
Q

What is the treatment for hypertonic uterine dysfunction?

A

sedation

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5
Q

Define adequate labor

A

> 6cm of dilation with membrane rupture and 4 or more hours of adequate contractions

or

no progress for more than 4 hours in nulliparous with epidural and 3 without

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6
Q

When is it arrest of second stage of labor?

A

No progress for more than 3 hrs without epidural

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7
Q

what is one possible reason for prolongation of the second stage of labor in women under epidural analgesia?

a. Failure of head flexion
b. Diminished pressure of uterine contractions
c. Failure of internal rotation
d. Failure to bear down because of fear of pain

A

b. Diminished pressure of uterine contractions

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8
Q

what is protraction disorder?

a. < 1.2 cm/hr cervical dilational in a nullipara
b. < 2 cm/hr cervical dilatation in a multipara
c. < 3 cm/hr descent of the presenting part in a nullipara
d. No progress in cervical dilataion and descent

A

a. < 1.2 cm/hr cervical dilational in a nullipara

1. 5 cm/hr multipara

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9
Q

if the latent phase has lasted for more than 16 hours, this is considered prolonged in:

a. Nullipara
b. Multipara
c. Both
d. neither

A

b. Multipara

> 20 hours nullipara
14 hours multipara

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10
Q

if the latent phase has lasted for more than 21 hours, this is considered prolonged in:

a. Nullipara
b. Multipara
c. Both
d. neither

A

c. both

> 20 hours nullipara
14 hours multipara

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11
Q

if the latent phase has lasted for more than 8 hours, this is considered prolonged in:

a. Nullipara
b. Multipara
c. Both
d. neither

A

d. neither

> 20 hours nullipara
14 hours multipara

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12
Q

Which units are the following reported in?

Prolongation Disorder
Protraction Disorder
Arrest Disorder

A

Prolongation Disorder - HRs
Protraction Disorder - CMs
Arrest Disorder - HRs

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13
Q

what is protraction disorder?

a. < 1.5 cm/hr cervical dilational in a nullipara
b. < 2 cm/hr cervical dilatation in a multipara
c. < 1 cm/hr descent of the presenting part in a nullipara
d. No progress in cervical dilataion and descent

A

c. < 1 cm/hr descent of the presenting part in a nullipara

< 2cm in multipara

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14
Q

Define prolonged disorder

A

latant phase lasting

> 20 hours nullipara
14 hours multipara

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15
Q

What two parameters can protraction disorder be defined?

A

cervical dilation

descent of presenting part

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16
Q

Define protraction disorder according to cervial dilation

A

< 1.2 cm/hr nullipara

<1.5 cm/hr multipara

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17
Q

Define protraction disorder according to descent of presenting part

A

< 1 cm/hr nullipara

< 2 cm/hr multipara

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18
Q

what is prolonged deceleration phase in a nullipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

d. > 3 hrs

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19
Q

what is prolonged deceleration phase in a multipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

b. > 1hr

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20
Q

What is failure of descent?

a. < 1.5 cm/hr cervical dilational in a nullipara
b. < 2 cm/hr cervical dilatation in a multipara
c. < 1 cm/hr descent of the presenting part in a nullipara
d. No progress in cervical dilation and descent

A

d. No progress in cervical dilation and descent

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21
Q

what is the diagnosis if the head has remained at station 0 in a nullipara with epidural after 2 hours in the second stage?

a. Arrest of descent
b. Failure of descent
c. Prolonged 2nd stage and arrest of descent
d. Prolonged 2nd stage and failure of descent

A

b. Failure of descent

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22
Q

what is the diagnosis if the head has remained at station 0 in a nullipara without epidural after 2 hours in the second stage?

a. Arrest of descent
b. Failure of descent
c. Prolonged 2nd stage and arrest of descent
d. Prolonged 2nd stage and failure of descent

A

d. Prolonged 2nd stage and failure of descent

23
Q

what is secondary arrest of dilation in nullipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

c. > 2 hrs

24
Q

what is secondary arrest of dilation in multipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

d. > 3 hrs

25
Q

What is arrest of descent in in nullipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

b. > 1hr

26
Q

What is arrest of descent in in multipara?

a. > 30 mins
b. > 1hr
c. > 2 hrs
d. > 3 hrs

A

b. > 1hr

27
Q

Define active phase arrest

A

No dilation for ≥ 2 hrs

28
Q

what is the diagnosis if the head has remained at station 0 in a multipara with epidural after 1 hours in the second stage?

a. Arrest of descent
b. Failure of descent
c. Prolonged 2nd stage and arrest of descent
d. Prolonged 2nd stage and failure of descent

A

b. Failure of descent

29
Q

what is the diagnosis if the head has remained at station 0 in a multipara without epidural after 1 hours in the second stage?

a. Arrest of descent
b. Failure of descent
c. Prolonged 2nd stage and arrest of descent
d. Prolonged 2nd stage and failure of descent

A

c. Prolonged 2nd stage and arrest of descent

30
Q

in which of the following is the pelvic inlet contracted?

a. The OC is less than 11 cm
b. The GTD is less than 13.5 cm
c. The DC is less than 11.5cm
d. The true conjugate is less than 12 cm

A

c. The DC is less than 11.5cm

31
Q

In a conctracted pelvic inlet what is the measurement of anteroposterior diameter?

a. 9.5 - 9.8 cm
b. < 10 cm
c. < 11.5 cm
d. < 12 cm

A

b. < 10 cm

32
Q

In a conctracted pelvic inlet what is the measurement of greatest transverse diameter?

a. 9.5 - 9.8 cm
b. < 10 cm
c. < 11.5 cm
d. < 12 cm

A

d. < 12 cm

33
Q

In a conctracted pelvic inlet what is the measurement of diagonal conjugate?

a. 9.5 - 9.8 cm
b. < 10 cm
c. < 11.5 cm
d. < 12 cm

A

d. < 12 cm

34
Q

What is normal parietal diameter?

a. 9.5 - 9.8 cm
b. < 10 cm
c. < 11.5 cm
d. < 12 cm

A

a. 9.5 - 9.8 cm

35
Q

Define precipitous labor

A

Labor < 3 hrs

36
Q

The anterior midpelvis is bounded by:

a. upper border of the symphysis pubis and the ischiopubic rami
b. lower border of the symphysis pubis and the ischiopubic rami
c. sacrum and sacrospinous ligament
d. sacrum and sacrotuberous ligament

A

b. lower border of the symphysis pubis and the ischiopubic rami

37
Q

The posterior midpelvis is bounded by:

a. upper border of the symphysis pubis and the ischiopubic rami
b. lower border of the symphysis pubis and the ischiopubic rami
c. sacrum and sacrospinous ligament
d. sacrum and sacrotuberous ligament

A

c. sacrum and sacrospinous ligament

38
Q

What three structures form the midpelvis?

A

. Lower symphysis pubis
. Ischial spine
. Sacrum

39
Q

the pelvic midplane is considered contracted in which of the following?

a. The IS is < 11 cm
b. The APM is 12 cm
c. The PSM is 5 cm
d. The IS + PSM is < 13.5 cm

A

d. The IS + PSM is < 13.5 cm

40
Q

the pelvic midplane is considered contracted in which of the following?

a. The IS is < 8 cm
b. The APM is 12 cm
c. The PSM is 5 cm
d. The IS + PSM is < 14.5 cm

A

a. The IS is < 8 cm
b. The APM is 12 cm
c. The PSM is 5 cm
d. The IS + PSM is < 14.5 cm

41
Q

The average midpelvis measurement for transverse

a. 5 cm
b. 8 cm
c. 10.5 cm
d. 11.5 cm

A

c. 10.5 cm

42
Q

The average midpelvis measurement for APM

a. 5 cm
b. 8 cm
c. 10.5 cm
d. 11.5 cm

A

d. 11.5 cm

43
Q

The average midpelvis measurement for PJM

a. 5 cm
b. 8 cm
c. 10.5 cm
d. 11.5 cm

A

a. 5 cm

44
Q

A pelvic outlet is contracted when the interischial tuberous diameter is less than

a. 5 cm
b. 8 cm
c. 10.5 cm
d. 11.5 cm

A

b. 8 cm

45
Q

Rank the following from most common to least common cause of pelvic contraction

Inlet
Midpelvis
Outlet

A

Midpelvis > Inlet > Outlet

46
Q

Anterior outlet triangle is bound by

a. inferior posterior surface of the symphysis pubis
b. interischial tuberous diameter
c. pubic rami
d. tip of the last sacral vertebra
e. tip of coccyx

A

a. inferior posterior surface of the symphysis pubis
b. interischial tuberous diameter
c. pubic rami

47
Q

Posterior outlet triangle is bound by

a. inferior posterior surface of the symphysis pubis
b. interischial tuberous diameter
c. pubic rami
d. tip of the last sacral vertebra
e. tip of coccyx

A

b. interischial tuberous diameter

d. tip of the last sacral vertebra

48
Q

which of the following id true about the pelvic outlet?

a. The IT is the common base between the 2
triangles
b. The apex of the posterior triangle is the tip of the
coccyx
c. The IT is contracted if it is < 10 cm
d. Pure outlet contraction is common

A

a. The IT is the common base between the 2
triangles

Ratio: The apex of the posterior triangle is the tip of the last sacral vertebra
The IT is contracted if it is < 8 cm
Pure outlet contraction is RARE

49
Q

Ways to estimate fetal head size

A

clinical - Mueller hillis maneuver

sonogram - fetopelvic index

50
Q

True or False

Feto pelvis dispropotion is predicted based on head size

A

FALSE - there is no satisfactory method

51
Q

What are maternal effects of dystocia

A

. Intrapartum infection
. Uterine rupture
. Pathological retraction - Ring of Bandl
. Fistula formation
. Pelvic floor injury
. Postpartum lower extrimity nerve injury

52
Q

What are the fetal effect of dystocia

A

. Caput succedaneum
. Fetal head molding
. Skull fracture

53
Q

What is the rate of cervical dilation in short labor?

A

Nullipara: 5cm/hr

Multipara 10cm/hr

54
Q

Short labor is associated with

A 
abruption
meconium
postpartum hemorrhage
cocaine abuse
low apgar score

Patho OB (12 decks)

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