Dysfunctional Labor, Uterine Contractility, and Dystocia Flashcards

1
Q

Maximal dilation and descent for a nulliparous woman?

A
  • 1.2 cm/hr

- 1.0 cm/hr

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2
Q

Maximal dilation and descent for Multiparous woman?

A
  • 1.5 cm/hr

- 2.0 cm/hr

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3
Q

If we are in the active phase of labor, how do we differentiate between a protraction disorder and arrest of dilation?

A
  • if cervical dilation is less than norms: protraction
  • if 2 or more hours elapse with no cervical dilation: arrest of dilation
  • same principle applies for fetal descent
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4
Q

What are the three P’s of the active phase?

A
  • Passage
  • Passenger
  • Power
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5
Q

When should the diagnosis of dystocia NOT be made?

A

-before an adequate trial of labor has been tried

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6
Q

When should we augment?

A

-if contractions are less than 3 in a 10 minute period

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7
Q

What can cause an abnormality of the Passage part of the active phase?

A

-Cephalopelvic disproportion (CPD)

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8
Q

Which types of pelvises do well with labor?

A

-gynecoid and anthropoid

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9
Q

What will ladies that are delivering with OP position have as a symptom?

A

-back discomfort

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10
Q

Define macrosomia

A

-4500 gms or more

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11
Q

What is the main risk associated with macrosomia?

A
  • damage to th nerves of the brachial plexus

- even though those are rare and usually resolve without any permanent injury *

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12
Q

What is it called when there is a brachial plexus injury?

A
  • erb-Duschenne palsy

- damage to C5 and C6 nerves

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13
Q

Klumpke palsy

A
  • lower arm palsy

- damage to C8 and T1

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14
Q

When does ACOG recommend a prophylactic c section in diabetic and non diabetic women?

A
  • diabetic: 4,500

- non: 5,000

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15
Q

What is the turtle sign associated with?

A

-shoulder dystocia

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16
Q

Where do we apply pressure when delivering a shoulder dystocia baby?

A
  • not fundal pressure
  • suprapubic pressure so we can push that shoulder out
  • McRobert’s maneuver
17
Q

What do we use as a last resort if we can’t deliver the baby with shoulder dystocia?

A
  • Zavanellie maneuver
  • cephalic replacement
  • poor prognosis
  • push it back up in vagina…. deliver by c section