Dystocia

Question 1

What is dystonia

Answer 1

dystonia is a long difficult labor

Question 2

Dystonia problems related to primary power

Answer 2

abnormal uterine contractions preventing normal cervical dilation and effacement

Question 3

dystonia precipitous powers

Answer 3

labor lasting less than 3 hrs; hypertonic contractions

Question 4

hypertonic uterine dysfunction related to dystonia

Answer 4

painful, frequent contractions that occur in the first phase of labor that are usually uncoordinated contractions where the uterus does not completely relax

Question 5

hypotonic uterine dysfunction related to dystonia

Answer 5

after active progression of labor progression becomes weak or stops all together

Question 6

cause for precipitous labor

Answer 6

multipara, large pelvis, small fetus, previous precipitous births, cocaine abuse

Question 7

treatment for precipitous labor

Answer 7

maternal uterine rupture, laceration of the birth canal, amniotic fluid embolism, fetal hypoxia, intracranial hemorrhage

Question 8

pelvic dystocia

Answer 8

contractures of the pelvic diameters reducing the capacity of the outlet

Question 9

causes for pelvic dystocia

Answer 9

congenital abnormalities, maternal malnutrition, neoplasm, lower spinal disorders

Question 10

fetal causes for dystocia

Answer 10

hydrocephalus, tumors, neural tube defects, cephalopelvic disposition, malposition, malpresentation, multifetal pregnancy

Question 11

what symptoms is present with fetus malposition (occipitoposterior)?

Answer 11

prolonged 2nd stage of labor, severe back pain

Question 12

treatment for malposition

Answer 12

rotate the fetus externally or c-section

Question 13

prolonged labor lasts….

Answer 13

more than 24hrs

Question 14

risks for prolonged labor

Answer 14

fatigue, pain, over distended uterus hemorrhage, hypoxic baby

Question 15

treatment of dystonia

Answer 15

positioning, augmentation of labor, monitor FHR, maternal VS, maternal comfort measures, communication and support

Question 16

cervical repening

Answer 16

chemical, mechanical or amniotomy

Question 17

chemical cervical repening

Answer 17

prostaglandin E (misoprostol) to soften an thin the cervix. this decreases the need to augment labor

Question 18

Mechanical Cervical Repening

Answer 18

Use of dilators and Foley catheters to stimulate and dilate the cervix

Question 19

Amniotomy cervical ripening

Answer 19

Artificial rupture of membranes

Question 20

mechanical ripening

Answer 20

mechanical dilators or Foley catheters to stimulate and dilate the cervix

Question 21

amniotomy

Answer 21

the artificial rupturing of membranes

Question 22

oxytocin

Answer 22

a chemical to induce labor that is produced in the posterior pituitary gland

Question 23

Complications with oxytocin

Answer 23

water intoxication, tetanic contractions, premature separation of the placenta, rupture of uterus, post partum hemorrhage

Question 24

prolapsed umbilical cord

Answer 24

when the cord lies below the presenting part of the fetus

Question 25

factors contributing to a prolapsed cord

Answer 25

long cord, fetal malpresentation, transverse lie, unengaged presenting part

Question 26

forceps-assisted birth

Answer 26

done to shorten the second stage of labor in the case of dystocia

Question 27

maternal risks and complications related to forceps-assisted birth

Answer 27

laceration of the birth canal, increased swelling, bleed, bruising, hematoma, pelvic floor injuries, increased urinary and rectal incontinence

Question 28

infant risks and complications related to forceps-assisted birth

Answer 28

cephalhematoma, hyperbilirubinemia, bruising on the face, facial paralysis, retinal hemorrhage, corneal abrasion, other ocular damage

Question 29

indication for vacuum assistance birth

Answer 29

prolonged second stage of labor, non reassuring heart rate pattern on the fetal strip, relives woman’s pushing efforts when fatigue interferes

Question 30

prerequisites for vacuum suction delivery

Answer 30

vertex presentation, ruptured membranes, absence of CPD

Question 31

fetal complications to vacuum suction delivery

Answer 31

scalp lacerations, bruising, cephalohematoma, neonatal jaundice, fractured clavicle, shoulder dystocia, Erb’s paralysis, damage to cranial nerves, retinal hemorrhage, fetal death