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Childbirth and complications Flashcards

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1
Q

Which statement is true?
A) In the case of hypotonic inadequate contractions, the uterine basal tone is normal, the contractions occur less frequently, last for a short time with low intensity.
B) In the case of hypertonic inadequate contractions, low amplitude contractions occur frequently, their duration increases, the basal tone is increased.
C) In the case of normotonic inadequate contractions, contractions occur frequently, their amplitude and duration is inadequate.
D) In the case of normotonic inadequate contractions, the uterine basal tone is low.

A

B) In the case of hypertonic inadequate contractions, low amplitude contractions occur frequently, their duration increases, the basal tone is increased.

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2
Q

Which statement is false?
A) Hyperkinetic disorders (too strong contractions) may be caused by increased excitability if uterine muscles.
B) Hyperkinetic disorders (too strong contractions) may be caused by the partial placental abruption.
C) Hyperkinetic disorders (too strong contractions) may be caused by placenta previa
D) Hyperkinetic disorders (too strong contractions) may be caused by cephalopelvic disproportion.

A

C) Hyperkinetic disorders (too strong contractions) may be caused by placenta previa

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3
Q

Improper manual revision of the uterine cavity may result in:
A) Complete or incomplete uterine rupture
B) The uterus may be torn from the vaginal fornix (colpaporrhexis).
C) Both
D) None

A

C) Both

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4
Q

What is the Bandl contraction ring?
A) Muscle ring located at the border of the cervix and corpus uteri
B) Retraction ring visible at the border of the active-passive section of the uterus during labor
C) The muscle ring in the vaginal vestibule during labor
D) The contraction ring at the upper third of the vagina when the cervix is fully dilated

A

B) Retraction ring visible at the border of the active-passive section of the uterus during labor

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5
Q

What is the Bracht-maneuver?
A) A maneuver used in vaginal delivery in case of breech presentation of the fetus
B) A maneuver used to manage the abrupted but not yet delivered placenta
C) A maneuver used for expelling the arms extended above the head
D) A maneuver used for expelling the stalled shoulders

A

A) A maneuver used in vaginal delivery in case of breech presentation of the fetus

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6
Q

Which statement is false?
A) Naegele and Litzmann obliquities are included in fetal malpresentations.
B) Asynclitism may be caused by flat pelvis and flabby abdomen.
C) In particular case of synclitism cesarean section should be performed.
D) Synclitism can be recognized after the 30th gestational weeks.

A

C) In particular case of synclitism cesarean section should be performed.

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7
Q

It can be a complication in transverse lie, except:
A) Uterine rupture
B) Fetal hand, shoulder prolapse
C) Umbilical cord prolapse
D) Placenta previa

A

D) Placenta previa

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8
Q

If the placenta is not delivered within 30 minutes in the third stage of labor, what should you do?
A) pull the umbilical cord to remove the placenta
B) intravenous prostaglandin helps to deliver the placenta
C) manual removal of the placenta is recommended
D) intracervical prostaglandin helps to remove the placenta

A

C) manual removal of the placenta is recommended

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9
Q

What kind of assisted vaginal delivery should be performed in the 32nd week of pregnancy, if the skull has crossed the pelvic entrance, the cervix disappeared, the membrane is ruptured and signs of intrapartum fetal distress occur?
A) Forceps
B) Vacuum extraction
C) Cesarean section
D) By pressing the fundus uteri and intravenous administration of 5 IU of Oxytocin, I would accelerate the delivery

A

A) Forceps

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10
Q

Which is characteristic for a partial abruption of the placenta?
A) uterine tenderness “deck hard”
B) heavy fresh bleeding occurs from the uterus
C) the amniotic fluid is pure
D) does not involve blood clotting disorder

A

A) uterine tenderness “deck hard”

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11
Q

Placenta previa is characterized by:
A) Pain localized in the uterus
B) The amniotic fluid is tinged by blood
C) The tone of the uterus is increased
D) Few or suddenly heavy, fresh bleeding without any other symptoms

A

D) Few or suddenly heavy, fresh bleeding without any other symptoms

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12
Q

A patient with 39 weeks pregnancy has one cesarean section in her history. The premature rupture of membranes occurs without contractions, the cervix is dilated to 3 cm. What to do?
A) Immediately intravenous administration of 5NU Oxytocin to cause contractions
B) In certain cases Oxytocin infusion can be used to amplify contractions
C) If the contractions are regular and the anatomical findings progress,but the first stage last more than 6 hours cesarean section should be performed
D) Immediate cesarean section

A

B) In certain cases Oxytocin infusion can be used to amplify contractions

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13
Q

It can lead to DIC, with the exception of:
A) missed abortion
B) umbilical cord prolapse
C) intrauterine fetal death
D) placental abruption

A

B) umbilical cord prolapse

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14
Q

What is the diagnosis if both feet are palpable in breech presentation and the legs are bent in the hip and knees?
A) Footling breech
B) Kneeling breech
C) Complete breech
D) Frank breech

A

C) Complete breech

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15
Q

Characteristic for RDS profilaxis:
A) antenatal corticosteroid therapy for fetal pulmonary maturation in preterm infants.
B) administration of 2 mg steroid orally required to reach the optimal effect till the delivery
C) optimal benefit begins 7 days after admnistration
D) by threatened abortion weekly intramuscular injection from the 20. gestation week is required.

A

A) antenatal corticosteroid therapy for fetal pulmonary maturation in preterm infants.

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16
Q

Absolute contraindications to regional anesthesia, except:
A) coagulopathy
B) sepsis or infection at needle insertion site
C) uncorrected hypovolemia
D) tricuspidal insufficiency

A

D) tricuspidal insufficiency

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17
Q

What should be done if the fetus’s arms are extended above the head during vaginal delivery?
A) Using the proper maneuver we deliver the arms of the fetus. (right arm with right hand, left arm with left hand)
B) Immediate cesarean section
C) By pulling the fetus, we change the position of the arms and deliver the fetus
D) We push the fetus back into the uterus, thereby we change the position of the arms and then continue the vaginal delivery

A

A) Using the proper maneuver we deliver the arms of the fetus. (right arm with right hand, left arm with left hand)

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18
Q

When are we talking about synclitism?
A) If the fetal sagital suture fits in the anterioposterior diameter of the pelvic brim instead of the transverse diameter.
B) If the fetal sagital suture fits in the transverse diameter of the pelvic inlet with equal distance from the symphisis and promontorium.
C) When the fetal sagital suture fits in the transverse diameter of the pelvic inlet closer to the promontorium or closer to the symphysis.
D) If the fetal sagital suture fits in the oblique diameter of the pelvic inlet.

A

B) If the fetal sagital suture fits in the transverse diameter of the pelvic inlet with equal distance from the symphisis and promontorium.

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19
Q

What is the position of the sagital suture during normal birth in different parts of the pelvic( inlet-canal-outlet) in normal internal rotation?
A) Inlet- transverse, canal-oblique, outlet- anterioposterior
B) Inlet- anterioposterior, canal- transverse, outlet- oblique
C) Inlet- transverse, canal- anterioposterior, outlet- oblique
D) Inlet- oblique, canal- transverse, outlet- anterioposterior

A

A) Inlet- transverse, canal-oblique, outlet- anterioposterior

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20
Q

Complications of induction of labor, especially induction with drugs:
A) Induction failure, weak contractions, prolonged birth
B) Tetanic uterine activity
C) Pelvic canal injuries, uterine rupture
D) All of the above

A

D) All of the above

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21
Q

The most common cause of postpartum hemorrhage:
A) Retained placental tissue
B) Overdistention of the uterus
C) Genital tract trauma
D) Uterine atony
E) Maternal coagulation disorders

A

D) Uterine atony

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22
Q

The most important role in postpartum hemorrhage is early detection and prevention. The following conditions prone to postpartum hemorrhage, except:
A) Postpartum hemorrhage in previous delivery
B) Multiple pregnancy
C) Quick detachment and delivery of the placenta
D) Inertia uteri, weak, irregular contraction

A

C) Quick detachment and delivery of the placenta

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23
Q

Meaning of IUGR:
A) Mental, growth and developmental retardation of fetus, caused by intrauterine hypoxia.
B) SGA (small for gestational age) fetus diagnosed by ultrasound examinations.
C) birth weight of a newborn infant is below the 10th percentile for a given gestational age
D) EBW (estimated birth weight) is below 2500 g

A

C) birth weight of a newborn infant is below the 10th percentile for a given gestational age

24
Q

In case of vaginal delivery of the fetus in breech presentation, the most vulnerable is the ……. of the fetus. Choose the most appropriate answer.
A) Respiratory system
B) Central nervous system
C) Musculoskeletal system
D) Cardiovascular system
E) Endocrine System

A

B) Central nervous system

25
Q

True for postpartum bleeding, except:
A) The most common cause is uterine atony, retained placental tissue, birth canal injuries
B) The most common site of bleeding is the bed of the placenta or vessels of the pelvic canal
C) Complicated delivery promotes postpartum bleeding
D) The most common cause of acute bleeding after birth is injuries of the vaginal wall or of the cervix
E) Postpartum bleeding may occur before and/or after the delivery of the placenta

A

D) The most common cause of acute bleeding after birth is injuries of the vaginal wall or of the cervix

26
Q

In multiple pregnancies, the most common cause of perinatal mortality is:
A) Placenta previa
B) Prolapse of umbilical cord
C) Fetal malformation
D) Placental abruption
E) Premature birth

A

E) Premature birth

27
Q

It may be an indication of cesarean hysterectomy (removal of the uterus at the time of cesarean delivery):
A) severe postpartum hemorrhage
B) uterus pathology, sterilization
C) severe intrapartum fetal infection
D) placenta acreta
E) all of the above

A

E) all of the above

28
Q

Possible reason for breech presentation:
A) Oligohydramnion
B) Deformation of the uterine cavity
C) Macrosomia
D) Premature birth
E) All of the above

A

E) All of the above

29
Q

Condition for vacuum extraction:
A) Fully dilatated cervix
B) Fetal head engaged into the pelvis
C) Matured fetus
D) Membrane is ruptured
E) All of the above

A

E) All of the above

30
Q

For operative vaginal delivery, forceps should be chosen in the following cases:
A) In the case of a large fetus, to overcome cephalopelvic disproportion
B) In the case of premature birth
C) Dorsoanterior transverse lie
D) Umbilical cord prolapse
E) Dorsoposterior transverse lie

A

B) In the case of premature birth

31
Q

Indication for cesarean section, except:
A) Previous myomectomy / uterine surgery
B) Cephalopelvic disproportion
C) Placenta praevia centralis
D) Low placental implantation
E) Previous two cesarean sections in anamnesis

A

D) Low placental implantation

32
Q

In transverse lie of the fetus, the safest method is
(choose the most appropriate answer).

A) Reversal and extraction of the fetus
B) Cesarean section
C) Operative vaginal delivery (forceps, vacuum)
D) External manipulation of the fetus to vertex presentation and operative vaginal delivery (foceps, vacuum)
E) All of the above

A

B) Cesarean section

33
Q

Placental abruption may result in:
A) maternal coagulopathy
B) maternal oliguria
C) fetal death
D) maternal hemorrhage
E) all of the above

A

E) all of the above

34
Q

The most appropriate method for treating coagulopathy during placental abruption is:
A) Fresh Whole Blood transfusion and iv. cristalloid
B) Thrombocyte suspension
C) Fibrinogen administration
D) Red blood cell mass

A

A) Fresh Whole Blood transfusion and iv. cristalloid

35
Q

Risk factors for abruptio placentae except:
A) maternal hypertension, preeclampsia
B) short umbilical cord
C) tobacco use
D) trauma
E) administration of low dose aspirin

A

E) administration of low dose aspirin

36
Q

DIC may occur in the following obstetric complication:
A) Amniotic fluid embolism
B) Intrauterine fetal death
C) Praeclampsia
D) Sepsis
E) All of the above

A

E) All of the above

37
Q

Maternal complications of polyhydramnios:
A) placental abruption
B) hypotonic inadequate contractions
C) postpartum hemorrhage
D) none of the above
E) all of the above

A

E) all of the above

38
Q

What kind of delivery mode is chosen for 38 weeks of pregnancy in the dorsoposterior transversal lie fetus if premature rupture of membrane occurred?
A) acute cesarean section
B) external cephalic version
C) Iv. administration of 5 IU Oxytocin to accelerate delivery
D) Iv. ergometrin is given to accelerate vaginal delivery

A

A) acute cesarean section

39
Q

Which statement is true?
A) In case of fourth degree perineal laceration the anterior wall of the rectum and the rectal mucosa is ruptured.
B) In case of second degree perineal laceration the anal sphincter is ruptured.
C) In case of a first degree perineal laceration the perineal muscles are ruptured.
D) The case of superficial form of second degree perineal injury is called ruptura frenuli.

A

A) In case of fourth degree perineal laceration the anterior wall of the rectum and the rectal mucosa is ruptured.

40
Q

Reasons for fetal intrauterine death, except:
A) placental abruption
B) umbilical cord prolapse
C) false umbilical cord knot
D) placental insufficiency with chronic hypoxia

A

C) false umbilical cord knot

41
Q

Characteristic for postterm pregnancy, except:
A) delivery happen between the 41st-42th gestational week
B) perinatal mortality is two-three times higher
C) fetal movement may decrease
D) often the accurate dating of the gestation is uncertain

A

A) delivery happen between the 41st-42th gestational week

42
Q

Characteristic for brow presentation, except:
A) Brow presentation is a type of deflexion presentation
B) In the case of brow presentation, the guiding point is the center of the forehead
C) The presenting diameter is the saggital suture
D) With an external examination, there is an indenture between the extended fetal head and the back

A

C) The presenting diameter is the saggital suture

43
Q

Relevant in the diagnosis of premature rupture of membranes, except:
A) During the examination, amniotic fluid is leaking from the vagina
B) Ultrasound examination
C) The patient complaints of watery vaginal discharge
D) Determination of vaginal fluid secretion of androstenedione

A

D) Determination of vaginal fluid secretion of androstenedione

44
Q

Deflexion presentations are:
1) Brow presentation
2) Occipitoposterior presentation
3) Face presentation
4) Asynclitic presentation

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) none of the answers are correct

A

B) 1st and 3rd answers are correct

45
Q

In the case of transversal lie, the proper care:
1) In case of membranes rupture, an immediate caesarean section should be performed.
2) In case of intact membrane, waiting until the 36th pregnancy week is allowed.
3) At 34 weeks of pregnancy, tocolysis should be managed in case of contractions.
4) In the case of a prolapsed fetal arm, an external positioning of the fetus is to be managed, in case of failure an urgent caesarean section is to be performed.
5) In the case of regular contractions, at 38th week of gestation vaginal delivery can be managed, in case of failure cesarean section should be performed.

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

A) 1st, 2nd and 3rd answers are correct

46
Q

Possible treatment in uterine atony:
1) Ligation of hypogastric artery
2) Manual revision (retained placental tissue removal)
3) Bimanual compression and massage of the uterine corpus
4) Supracervical or total hysterectomy
5) Administration of iv. infusion, transfusion of packed red blood cells and FFP

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

D) all of the answers are correct

47
Q

Absolute indication of cesarean section in twin pregnancies:
1) Breech-Vertex presentation of twins (twin “A” is in breech, twin “B” is in cephalic presentation)
2) Vertex-vertex presentation in term
3) Premature twins in transverse-transverse presentation
4) Vertex-Breech presentation (twin A in cephalic, twin B in breech presentation)
5) Multiparous patient, vertex-vertex presentation (twin A in cephalis, twin B in cephalic presentation)

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

B) 1st and 3rd answers are correct

48
Q

It is true for management of premature birth:
1) Episiotomy is not necessary
2) Vacuum extraction should be carried out to facilitate the second stage of birth
3) Cesarean section should be performed in all premature birth
4) External rotation into cephalic presentation in malpresentations is recommended
5) Forceps may be used during second stage of birth

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

E) only the 5th answer is correct

49
Q

It is true for management of premature birth:
1) Vacuum extraction should be carried out to facilitate the second stage of birth
2) Cesarean section should be performed in all premature birth
3) Episiotomy is contraindicated
4) In preterm breech presentation, a vaginal birth is recommended
5) Episiotomy should be performed

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

E) only the 5th answer is correct

50
Q

Characteristic for macrosomy
1) fetal weight for a term pregnancy is above 90 percentile
2) incidence of shoulder dystocia is higher
3) may result from maternal or gestational diabetes
4) higher rate of perinatal mortality or morbidity

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) none of the answers are correct

A

D) all of the answers are correct

51
Q

Which statements are true for face presentation?
1) incidence is about 1 in 500 deliveries
2) when delivered spontaneous vaginal delivery, perinatal morbidity is similar to vertex presentation
3) if the guiding point (mentum) rotates posteriorly, vaginal delivery is impossible
4) vacuum –assisted vaginal delivery is recommended

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) none of the answers are correct

A

A) 1st, 2nd and 3rd answers are correct

52
Q

Predisposing factors for umbilical cord prolapse are:
1) Malpresentations
2) Long umbilical cord (longer than 80 cm)
3) Polyhydramnion
4) Oligohydramnion

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) none of the answers are correct

A

A) 1st, 2nd and 3rd answers are correct

53
Q

Maternal consequences of prolonged labor could be:
1) Uterus rupture, obstetric fistulas developing
2) Fetal distress
3) Heavy postpartum haemorrhage
4) Intrauterine fetal demise
5) Fetal brain injury

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

B) 1st and 3rd answers are correct

54
Q

The fetal consequences of prolonged labor could be:
1) Intrauterine fetal demise
2) Stillbirth
3) Fetal infection
4) Perinatal exitus
5) Fetal distress

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

D) all of the answers are correct

55
Q

Types of breech presentation, except:
1) Frank breech presentation
2) Asynclitic presentation
3) Incomplete breech presentation
4) Occipitoposterior presentation
5) Complete breech presentation

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

C) 2nd and 4th answers are correct

56
Q

Which statement is true of second degree perineal laceration?
1) The perineal muscles could be injured
2) Sphincter ani externus injury
3) The sphincter ani externus remains intact
4) The front wall of the rectum is damaged
5) The mucosa of the intestine is ruptured

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) only the 5th answer is correct
F) none of the answers are correct

A

B) 1st and 3rd answers are correct

57
Q

What should be done if umbilical cord prolapse is diagnosed?
1) Tocolysis can be considered while preparing for CS
2) Mother adopting the knee-chest position to reduce cord compression
3) It is recommended that the presenting part be elevated manually to prevent cord compression
4) Emergency cesarean section

A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) all of the answers are correct
E) none of the answers are correct

A

D) all of the answers are correct

gyno states (9 decks)

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