Dysfunctioanl Labor - Moulton

Question 1

What may be the cause of dystocia?

Answer 1

Macrosomia
Shoulder dystocia
Fetal anomalies

Question 2

Main sx of persistent OP position?

Answer 2

Severe back pain

Question 3

What is macrosomia?

Large for gestational age?

Answer 3

> 4500 gms

Birth weight > 90% for a given gestational age

Question 4

Erb-Duschenne injury is to what nerves?

What palsy?

What else?

Answer 4

C5, C6

Upper arm palsy

Most common brachial plexus injury

E before K so C5 before C8

Question 6

What is the 1st maneuver performed w/shoulder dystocia?

What is it?

Answer 6

McRobert’s

Hyperflexion and abduction of maternal hips

Josh McRoberts is a hyper baby bitch

Question 9

What is a cephalic replacement last resort maneuver for shoulder dystocia?

Answer 9

Zavanelli

Poor prognosis

Question 11

What are the risks of artificial membrane rupture?

Answer 11

Cord prolapse

Chorioamnionitis

Question 12

What is defined as delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders?

Answer 12

Shoulder dystocia

Question 13

What forceps are used for persistent OT position?

Answer 13

Keilland

KOT the baby

Question 14

What secondary maneuver may help w/shoulder dystocia?

Answer 14

Suprapubic pressure

Not fundal pressure

Question 15

What maneuver places pressure on an accessible shoulder to push it towards the anterior chest wall of the fetus to decrease the bisacrominal diameter and free the impacted shoulder?

Answer 15

Rubin

Question 16

What maneuver applies pressure behind the posterior to rotate the infant and dislodge the anterior shoulder?

Answer 16

Wood’s corkscrew

Question 18

What is retraction of the delivered fetal head against the maternal perineum?

Answer 18

Turtle sign

I like turtles

Question 21

What are the normal limits of the latent phase of labor in a nulliparous woman?

Multiparous?

Answer 21

20 hours

14 hours

Question 24

What are 4 causes of active phase abnormalities?

Answer 24

Inadequate uterine activity
Cephalopelvic disproportion
Fetal malposition
Anesthesia

Question 25

What refers to stimulation of uterine contraction when spontaneous contractions have failed to result in progressive cervical dilation or descent of the fetus?

Answer 25

Augmentation

Question 27

What does a + 50-g glucose screen w/a negative result on 3 hour mean?

Answer 27

RF for macrosomia

Question 29

ACOG recommends prophylactic C section for babies weighing what in non diabetic pts?

In diabetic pts?

Answer 29

> 5,000 gms

> 4,500 gms

Question 31

How do you manage persistent OT position?

Answer 31

Start oxytocin
Rotation manually or w/forceps
C section

Question 32

Minimal effective uterine activity defined how?

Answer 32

3 contractions in a 10 minute period avg 25 mmHg above baseline

Question 33

Klumpke is what nerve injury?

What palsy?

Answer 33

C8 and 1st thoracic nerve

Lower arm

Question 35

Persistent OT position w/arrest of descent for a period of 1 hr or more known as what?

Seen at what stations?

Answer 35

Transverse arrest of descent

+1 and +2

Question 40

What can cephalopelvic disproportion cause?

Answer 40

Failure of descent

Question 44

What is the minimum max dilation of the cervix in a nulliparous woman?

Minimum descent?

Answer 44

1.2 cm

1 cm

Question 47

What is the minimum max dilation of the cervix in a multiparous woman?

Minimum descent?

Answer 47

1.5 cm

2 cm