Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OBSTETRICS 2 > Dystocia > Flashcards

Dystocia Flashcards

1
Q

Most common indication for primary CS delivery

A

Dystocia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Characterized by abnormally slow progress of labor

A

Dystocia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is TRUE LABOR?

A

There are regular uterine contractions with associated change in cervix effacement and dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hardest part of all stages of labor

A

Stage 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the first stage of labor?

A

From regular uterine contraction to full cervical dilation (10cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the 4th stage of labor?

A

One hour after the 3rd stage, recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the third stage of labor?

A

From delivery of the baby to placental expulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 phases of cervical dilation

A

Latent Phase and Active Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Subdivisions of the Active phase of Cervical Dilation

A

Acceleration Phase
Phase of Maximum Slope
Deceleration Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Start of the preparatory division of labor

A

Latent phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The latent phase commences with:

A

Maternal perception of regular uterine contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The latent phase ends between ___________ cervical dilation

A

3 cm to 4 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

This phase determine the ultimate outcome of labor

A

Acceleration phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This phase is a good measure of overall efficiency of the uterus/machine (efficiency of uterine contraction)

A

Phase of Maximum Slope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

This phase reflects the feto-pelvic relationship

A

Deceleration phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The deceleration phase starts at _____ cm dilation

A

7-8cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three functional divisions of labor?

A

Preparatory
Dilatational
Pelvic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which functional division of labor is sensitive to sedation and analgesia?

A

Preparatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The preparatory division of labor includes which phases of cervical dilation?

A

Latent and Acceleration Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which functional division of labor shows change in connective tissue components of the cervix (e.g., cervical softening)?

A

Preparatory division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The Dilatational division of labor is in line with which subdivision of the active phase?

A

Phase of maximum slope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which of the three functional divisions of labor commences with the deceleration phase of cervical dilatation?

A

Pelvic division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In which of the three functional divisions of labor the cardinal movements (ED-FIRE-ERE) occur?

A

Pelvic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The cervical dilatation in the Friedman curve exhibits which shape?

A

Sigmoidal curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The Fetal Head descent in the Friedman curve exhibits which shape?

A

Hyperbolic curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Average rate of fetal head descent in Nulliparous women:

A

1 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Average rate of fetal head descent in Multiparous women:

A

2 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

According to the WHO, the Latent phase should not last more than _____ hours

A

8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the minimum hour delay in cervical dilation recommended for intervention as per the WHO partograph?

A

4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which of the following was developed for the purpose of improving labor management, “reducing maternal and perinatal morbidity and mortality” due to obstructed labor?

A

WHO partograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which set of the Modified WHO partograph (2006) focuses on the fetus?

A

2nd set

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The 1st set of the Modified WHO partograph (2006) relates to the progress of which events during labor?

A

Cervical dilation
Descent of the fetal head
Uterine contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which phase is not observed in the Modified WHO partograph (2006)?

A

Latent Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which partograph presents the revolutionary steps towards individualized labor care?

A

WHO Next Generation Partograph (2021) or the
WHO Labour Care Guide (2021)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

As per the WHO Labour Care Guide, the active phase stats from ____ cm of cervical dilatation

A

5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Between the Modified WHO Partograph and WHO Labor Care Guide, which one records the strength, duration, and frequency of uterine contractions?

A

Modified WHO Partograph

The WHO Labour Care Guide records only the duration and frequency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which labor cares were added in the WHO Next Generation Partograph of 2021?

A
  1. Second stage monitoring
  2. Supportive care interventions (companionship, pain relief, oral fluid intake, and posture) recording
  3. Requirement to respond to deviations from expected observations of any labor parameter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Zhang’s labor pattern recommended that labor be allowed to continue for a longer period of time, before ___ cm dilatation, to reduce the rate of intrapartum and subsequent repeat CS

A

6 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Rate of cervical dilatation for Nulliparous women (Zhang)

A

0.5-0.7 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the threshold for active labor according to Zhang?

A

6 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Rate of cervical dilatation for Multiparous women (Zhang)

A

0.5-1.3 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

The 2nd stage of labor lasts for ___ hours as per the 95th percentile for nulliparas WITHOUT epidural anesthesia.

A

2.8 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The 2nd stage of labor lasts for ___ hours as per the 95th percentile for nulliparas with epidural anesthesia.

A

3.6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the purpose of the Friedman’s curve?

A

To define the normal labor pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the purpose of Zhang’s labor pattern?

A

To prevent premature caesarian section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the shape of the labor curve for WHO partograph (cervical dilation)?

A

Diagonal or straight lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the shape for the Zhang labor pattern curve (cervical dilation)?

A

Exponential staircase line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

The cervical dilation progression pattern as per Friedman is ____ cm/hr for nulliparas and ____ cm/hr for multiparas

A

Nulliparas 1.2 cm/hr cervical dilation
Multiparas 1.5 cm/hr cervical dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

The action line of the WHO partograph is ___ hours from alert line

A

4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cervical dilation during the active labor as per the WHO partograph is ___ cm/hr

A

<1 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which labor pattern validity and usefulness historically governs the labor management?

A

Friedman’s curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the Maternal Effects of Dystocia

A
  1. Intrapartum Infection
  2. Postpartum hemorrhage from atony
  3. Pathological retraction ring of Bandl
  4. Uterine rupture
  5. Fistula formation
  6. Pelvic floor injury

mnemonic: PIPPUF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Fetal Effects of Dystocia

A

Caput succedaneum
Cephalohematoma
Molding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

This fetal effect of dystocia results from mechanical trauma of the initial portion of the scalp of the baby pushing though a narrowed cervix in a prolonged or difficult delivery

A

Caput succedaneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

This fetal effect of dystocia results from the rupture of a periosteal capillary due to pressure of birth or instrumental delivery

A

Cephalohematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

This fetal effect of dystocia manifests as swelling that extends across the midline and over suture lines

A

Caput succedaneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

This fetal effect of dystocia results to swelling of infant’s head for 24 to 48 hours after birth, manifested as clear edges that end at the suture lines

A

cephalohematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Abnormal labor pattern manifested as slower rate of cervical dilation or descent

A

Prolongation or Protraction disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

This type of abnormal labor pattern of fast delivery can result to intracranial hemorrhage and atony

A

Precipitate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How many percent of patients with prolonged or protracted disorders had cephalo-pelvic disproportion (CPD)?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the criteria for prolonged latent phase for nulliparas and multiparas?

A

Nullipara: >20 hours
Multipara: >14 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the criteria for protracted active phase for nulliparas and multiparas?

clue: same cervical dilatation reference as to Friedman

A

Nullipara: <1.2 cm/hr
Multipara: <1.5 cm/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

This pertains to arrested cervical dilatation at 8-9 cm beyond the normal duration

A

Prolonged deceleration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the criteria for prolonged deceleration for nulliparas and multiparas?

A

Nullipara: >3 hours
Multipara: >1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How many percent of patients with arrest disorders have cephalo-pelvic disproportion?

A

45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

This is defined as prolonged latent phase

A

Prolongation disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Which of the following is not an etiology of prolongation disorder?
A. Excessive sedation
B. Unfavorable cervix
C. False labor
D. Uterine dysfunction
E. Absence of painful sensation

A

E. Absence of painful sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How many percent of patients with prolongation disorder had false labor?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How many percent of patients with prolongation disorder had ineffective contraction and will benefit from oxytocin stimulation?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

A multipara at 15 hours of latent phase will benefit from which management according to POGS (2019)?

A

Observation, rest, and therapeutic analgesia or strong sedatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

The OCCC admonish against cesarian delivery in the latent phase of labor in the abscence of indications such as:

A

CPD
Fetal distress (e.g., abnormal FHR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Abnormal labor pattern that occurs during the first stage of labor, characterized by slow progress of cervical dilatation

A

Protraction disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the criteria for protracted descent disorder for nulliparas and multiparas?

clue: same average rate of fetal head descent as to Friedman

A

Nullipara: < 1 cm/hr
Multipara: < 2 cm/hr

72
Q

According to the POGS (2019), ______ shortens labor in protracted active phase by as much as 2 hours compared to expectant care.

A

Aminiotomy with early oxytocin augmentation

73
Q

In the recommendations of POGS (2019) for protracted active phase, oxytocin should be used to achieve adequate contractions of ____ MVU vefore operative delivery is considered.

A

200 MVU

74
Q

Arrest disorder occurs when cervical dilatation stops at ____ hours for both nulligravid and multigravid.

A

> 2 hours

75
Q

Failure of descent is no change of descent from fetal station 0 or higher in the deceleration phase or the second stage of labor/ pelvic division of ____ hour

A

> 1 hour

76
Q

This is noted when cervical dilation does not progress for more than 2 hours below the deceleration phase at the maximum slope

A

Secondary arrest of cervical dilation

76
Q

This is noted when progressive descent abruptly stops during pelvic division (may be beyond station 0) for > 1 hour

A

Arrest of descent

77
Q

The OCCC recommends CS delivery for active-phase arrest to be reserved for women at or beyond ____ cm of dilatation with ___________ who fail to progress despite ____ hours of adequate uterine activity.

A

CS delivery for active-phase arrest to be reserved for women at or beyond 6 cm of dilatation with ruptured membrane who fail to progress despite 4 hours of adequate uterine activity.

78
Q

The OCCC recommends CS delivery for active-phase arrest to be reserved for women having at least _____ hours of oxytocin administration with inadequate contractions and no cervical change.

A

6 hours

78
Q

Prolonged 2nd stage of labor when there is no progress for _____ hour/s in nulliparous and multiparous without regional anesthesia

A

Nulliparous > 2 hours
Multiparous > 1 hour

79
Q

Prolonged 2nd stage of labor when there is no progress for _____ hour/s in nulliparous and multiparous WITH regional anesthesia

A

Nulliparous > 3 hours
Multiparous > 2 hours

80
Q

Before 2nd stage labor arrest is diagnosed
→ Allow a nullipara to push for at least __ hours
→ Allow a multipara to push for at least __ hours

A

Before 2nd stage labor arrest is diagnosed
→ Allow a nullipara to push for at least 3 hours
→ Allow a multipara to push for at least 2 hours

81
Q

Precipitate second stage of labor is delivery in _____ hours

A

Less than 3 hours

82
Q

What are the etiologies of precipitate 2nd stage of labor?

A
  1. Abnormal low resistance of soft parts of the birth canal
  2. Abnormal strong uterine and abdominal contractions
  3. Absence of painful sensations and thus lack of awareness of vigorous labor
83
Q

What are the maternal effects of precipitate labor?

A
  1. Uterine rupture and extensive lacerations due to vigorous uterine contractions combined with a long, firm cervix and non-compliant birth canal
  2. Amniotic fluid embolism
  3. Uterine atony and postpatum hemorrhage
84
Q

What are the fetal and neonatal effects of precipitate labor?

A
  1. Increased perinatal mortality and morbidity
  2. Intracranial trauma
85
Q

Which part has the greatest and longest myometrial activity?

A

Fundus

*Fundal dominance

85
Q

What is the lower limit of contraction pressure required to dilate the cervix?

A

15 mmHg

86
Q

Normal spontaneous contraction pressure

A

60 mmHg

87
Q

Uterine activity where clinical labor starts

A

80-120 MVU

88
Q

Types of uterine contraction dysfunction

A

Hypotonic
Hypertonic

89
Q

This pertains to the increase in uterine pressure above the baseline tone in 10-minute period

A

Montevideo units

90
Q

Pressure of adequate uterine contractions

A

200 MVU

91
Q

Pertains to inadequate uterine contraction

A

< 180 MVU

92
Q

Uterine dysfunction with NO basal hypertonus

A

Hypotonic uterus

93
Q

TRUE or FALSE:
A hypotonic uterus has a synchronous uterine dysfunction

A

TRUE

94
Q

What is the management for a Hypotonic uterus

A

Augmentation by Oxytocin

95
Q

Preparation of oxytocin for hypotonic uterus

A

10 U oxytocin in 1L D5W

96
Q

Appropriate infusion rate of Oxytocin

A

30-40 mL/min

97
Q

Half-life of oxytocin

A

3 minutes

98
Q

Cardiovascular side effects of oxytocin

A
  1. Transient fall in BP with abrupt increase in CO
  2. ECG changes in MI
  3. Increase in mean pulse rate
99
Q

The antidiuretic action of Oxytocin can cause:

A

water intoxication

100
Q

Uterine dysfunction of increased in basal tone of approximately 25-40 baseline pressure

A

Hypertonic or incoordinate uterus

101
Q

Pertains to a distorted uterine pressure gradient

A

Hypertonic uterus

102
Q

Management of hypertonic uterus

A

Sedation

103
Q

Uterine Activity is quantified as the number of contractions present in a ___-minute window, averages over ___ minutes

A

The number of contractions present in a 10-minute window, averaged over 30 minutes

104
Q

Normal uterine activity

A

5 contractions or less in 10 minutes

105
Q

Pertains to >5 uterine contractions in 10 minutes, qualified as to +/- of associated fetal heart rate decelerations

A

Uterine tachysystole

106
Q

What are the specific abnormalities in the passenger that causes dystocia:

clue: Fat Baby Tiger Came Pouncing Squirrels

A
  1. Face presentation
  2. Brow Presentation
  3. Transverse lie
  4. Compound lie/presentation
  5. Persistent Occiput Posterior
  6. Shoulder Dystocia
107
Q

Presenting part of Face presentation

A

chin or mentum

108
Q

Presenting diameter for face presentation (give the normal)

A

Submento-bregmatic diameter of 9.5 cm

109
Q

Which Face presentation position is an indication for CS?

A

Mentum posterior

  • mentum anterior is possible for vaginal delivery but prolonged
110
Q

Etiologies of face and brow presentation:

A

● Marked enlargement of the neck or coils of cords
● Anencephalic fetus (usual for face presentation)
● Contracted pelvis
● Very large fetus
● Pendulous abdomen
● High parity (relaxed abdominal muscles)

111
Q

Recommendations for Face presentation

A

● CS is frequently indicated
● Continuous Electronic Fetal Monitoring
● Oxytocin if mentum anterior, adequate pelvis, and reassuring FHR
● Forceps for mentum anterior

112
Q

Maneuver used to convert face to vertex presenation or rotating mentum posterior position to mentum anterior (NOT RECOMMENDED due to high perinatal morality)

A

Thom Maneuver

113
Q

Presenting diameter for brow presentation (give normal)

A

vertico-mental diameter of 13.5 cm

114
Q

Rarest presentation

A

Brow presentation

115
Q

This presentation denotes an impossible engagement

A

Brow Presentation

116
Q

POGS 2009 recommendation for Brow presentation

A

Expectant management for spontaneous conversion to vertex or face

117
Q

Which interventions are contraindicated for Brow Presentation?

A

Forceps delivery and manual conversion

118
Q

This is noted when shoulder of the fetus may be impacted firmly in the upper part of the pelvis

A

Neglected transverse lie

119
Q

A gridiron feel on vaginal exam signifies which lie?

A

transverse lie

120
Q

Which of the following is not a common etiology of transverse lie?
● Unusual relaxation of the abdominal wall
● Anencephaly
● Preterm fetus
● Placenta previa
● Abnormal uterus
● Polyhydramnios

A

Anencephaly = face or brow presentation

121
Q

Pertains to fetus doubled/ folded upon itself

A

Conduplicato corpore

122
Q

In doing CS for a transverse lie, ___________ is often indicated

A

Vertical hysterectomy

123
Q

Abnormality in passenger when extremity prolapses alongside the presenting part and both present simultaneously in the pelvis

A

Compound lie

124
Q

This is more likely to occur when the pelvis is not fully occupied by the fetus

A

Compound lie

125
Q

During the course of labor of a passenger in compound lie, the prolapsed part should be:

A

left alone

126
Q

What can be done if the prolapsed part fails to retract during compound lie labor?

A

the prolapsed arm should be pushed gently upward and the head simultanously downward by fundal pressure

127
Q

TRUE or FALSE:
Oxytocin augmentation can be given in a patient with compound presentation

A

False because this may cause uterine rupture

128
Q

This abnormal passenger presentation results to a severe painful labor

A

Persistent Occiput Posterior

129
Q

The most common presentation indicating CS

A

Persistent Occiput Posterior

130
Q

Shoulder dystocia is described as “anterior shoulder against _________”

A

Pubic symphysis

131
Q

This abnormal passenger presentation is increased due to bigger babies common in obese, multiparous, and diabetic mothers

A

Shoulder dystocia

132
Q

Sign of transient brachial plexus palsies common in shoulder dystocia

A

Waiter’s Tip sign

133
Q

Estimated fetal weight indicating CS for non-diabetic moms

A

> 4.5 kg

134
Q

Estimated fetal weight indicating CS for diabetic moms

A

> 5 kg

135
Q

This is the most frequently used maneuver for shoulder dystocia

A

Mazzanti maneuver or Modified Suprapubic Pressure

136
Q

Surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis for shoulder dystocia

A

Symphysiotomy

137
Q

In deliberate fracture of the clavicle, the thumb is used to press the clavicle against the _________.

A

pubic ramus

138
Q

This is the cutting of the clavicle with scissors for the management of shoulder dystocia

A

Cleidotomy

139
Q

Maneuver for shoulder dysplacia wherein the thighs and knees are sharply flexed up onto the abdomen while pressure is applied on the suprapubic area

A

McRobert’s Meneuver

140
Q

Maneuver for Shoulder Dystocia wherein pressure is applied to the anterior aspect of the posterior shoulder rotating it to the anterior position

A

Wood Corkscrew maneuver

141
Q

Shoulder dystocia maneuver wherein the more easily accessible fetal shoulder is pushed toward the anterior chest of the fetus, abducting both shoulders, reducing the shoulder-to-shoulder diameter and freeing the impacted shoulder

A

Rubin Maneuver

142
Q

Last resort maneuver typically indicated for dead baby, done by returning the head to the occiput anterior/posterior position by flexing the head and pushing it back into the vagina

A

Zavanelli Maneuver

143
Q

Maneuver for Shoulder Dystocia wherein pressure is applied to the fetal jaw and nech in the direction of the maternal rectum, with strong fundal pressure applied as the anterior shoulder is freed

A

Hibbard maneuver

144
Q

Gentle downward pressure to the posterior shoulder, the anterior shoulder may become more impacted but will facilitate the freeing up of the posterior shoulder

A

Gaskin Maneuver

145
Q

ALARMER

A

Ask for help
Lift the leg
Anterior shoulder disimpaction
Rotation of the Posterior shoulder
Manual removal of the Posterior Shoulder
Episiotomy
Roll over into “all fours” position

146
Q

Patients with poorly controlled DM is recommended to delivery at ____ AOG

A

37 weeks

146
Q

Does labor induction prevent shoulder dystocia in non-diabetic mothers?

A

NO

147
Q

Patients with well controlled GDM is recommended to delivery at ____ AOG

A

40 weeks

148
Q

Does labor induction prevent shoulder in dystocia in patients with GDM/DM?

A

YES

149
Q

CS may be considered in DM mothers with EFW of:

A

> 4 kg

150
Q

Distance from the anterior lower border of the pubis to sacral promontory

A

Diagonal Conjugate

151
Q

Normal DC

A

11.5 cm

152
Q

The narrowest diameter of the pelvic inlet

A

Obstetric conjugate

153
Q

Formula for OC

A

DC - 1.5

154
Q

Normal OC

A

10 cm

155
Q

Most important measurement in the pelvic inlet

A

Obstetric conjugate

156
Q

Upper margin of pubis to sacral promontory

A

True or Anatomic Conjugate (TC or AC)

157
Q

Formula for True Conjugate

A

DC - 1.2

158
Q

Normal TC

A

11 cm

159
Q

Feature of Contracted Pelvic Inlet

A
  • Obstetric Conjugate (OC): <10cm
  • Diagonal Conjugate: <11.5cm
160
Q

Narrowest diameter of pelvic cavity

A

Interspinous diameter

161
Q

Distance between the sacrum and a line created by the interspinous diameter

A

Post-sagittal diameter

162
Q

The largest diameter in the pelvic cavity

A

Transverse diameter

163
Q

The transverse diameter is the distance between the:

A

linea terminalis

164
Q

Interspinous diameter that suggests contracted midpelvis

A

< 8 cm

(normal is 10.5cm)

165
Q

Normal post-sagittal diameter of the midpelvis

A

4.5 cm

166
Q

IS + PS that suggest contracted midpelvis

A

≤ 13.5 cm (normal is 15.5 cm)

167
Q

3 anatomical features that suggest midpelvic contraction

A

→ Spines are prominent
→ Pelvic sidewalls converge
→ Narrow sacrosciatic notch

168
Q

Anatomical Level or Landmark of the Pelvic Outlet

A

Ischial tuberosity

169
Q

Anatomical Level or Landmark of the Pelvic Inlet

A

Symphysis pubis

170
Q

Anatomical Level or Landmark of the Midpelvis

A

Ischial spine

171
Q

Normal Interspinous diameter

A

10.5 cm

172
Q

Narrowest distance of the Pelvic Outlet

A

Transverse diameter

173
Q

The Transverse diameter is the distance between:

A

Inner edges of the ischial tuberosity

174
Q

Inter-ischial tuberous diameter that indicates contraction:

A

< 8 cm (normal is 11.0 cm → Transverse diameter)

175
Q

Management for Pelvic outlet contraction

A

Episiotomy

176
Q

The pathological retraction ring of Bandl signify:

A

impending rupture of the lower uterine segment

OBSTETRICS 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions