GUM 114 Pregnancy

Question 1

What does gravida mean?

Answer 1

Means pregnant now. Small x is no of pregnancies current and previous

Question 2

What does parity mean?

Answer 2

Success or otherwise of previous pregnancies

y+z is the number of viable deliveries + unsuccessful pregancies

Question 3

What is caput?

Answer 3

Oedema of the baby’s scalp due to pressure against the rim of the pelvis

Question 4

What is moulding?

Answer 4

Overlapping of the bones of baby’s skull

Question 5

What is engagement? When is the head said to be engaged?

Answer 5

Descent of the biparietal diameter through the pelvic brim. When there is only 2/5 palpable per abdomen

Question 6

What is the lie and what 3 planes can it be in?

Answer 6

Relation of long axis of foetus to the mother

Longitudinal (normal), oblique and transvere

Question 7

What is presentation in pregnancy? Name the three types

Answer 7

Part of the foetus in the lower pole of the uterus
Cephalic: head presenting
Vertex: baby in transverse lie
Breech: bottom and feet presenting

Question 8

What is the position in pregnancy? And what is the normal position for a foetus

Answer 8

Relation of presenting part of baby to pelvis

Direct occippito anterior

Question 9

What is attitude in pregnancy?

Answer 9

Degree of flexion or extension of the foetal head

Question 10

What is station used to describe in pregnancy?

Answer 10

Relation of foetal head to ischial spines
-3cm = 3cm above spines
0= level of spines
+4 = OUT

Question 11

How many stages of labour are there?

Answer 11

Three

Question 12

Describe the onset of labour to the cervix being fully dilated

Answer 12

Latent stage: onset - 4cm dilation and effacement occurs

Active stage: 4cm- full dilatation

Question 13

What is effacement?

Answer 13

Thinning of the cervix as the internal os becomes incorporated into the cervix

Question 14

Describe full dilatation to delivery

Answer 14

Propulsive phase where the baby is propelled by uterine contractions at full dilatation till the head meets the pelvic floor.
Expulsive phase where there is an irresistible urge to push and the baby is expelled by pelvic floor muscles

Question 15

Describe afterbirth

Answer 15

Explusion of placenta and membranes

Question 16

Describe the mechanism of normal birth

Answer 16

Engagement and descent - head engages in LOL position and descents past pelvic brim

Flexion - chin tucks up to chest so smallest presenting diameter

Internal rotation - head turns to DOA, foetus rotates as it hits the pelvic flood, head rotates to DOA

Extension - head and neck extends, delivering head

External rotation and resititution - head returns to LOL to allow easier passage of shoulders

Question 17

What is oxytocin? And what is the synthetic hormone called?

Answer 17

An endogenous hormone secreted by the pituitary.
Causes effacement and stimulates uterine contractions
Syntocin: quick acting, short half-life - short contractions

Question 18

What is ergometrine?

Answer 18

Induces tetanic contraction (prolonged spasm) used in post partum haemorrhage
NB: older drug, oxytocin is preffered

Question 19

What is syntometrine?

Answer 19

Oxytocin and ergometrine so quick acting and long lasting contractions and used in post partum haemorrhage

Question 20

What is dinoprosotone?

Answer 20

A PGE2 analogue that ripens and effaces the cervix in the induction of labour