ICR-Obstetrics

Question 1

Gravidity

Answer 1

Pregnancies

Question 2

Parity

Answer 2

Delivery events

Question 3

What does P2002 mean?

Answer 3

2 at full term and 2 living children with no preterm deliveries or abortions. (FPAL)

Question 4

ROM

Answer 4

Rupture of membranes (spontaneous, preterm)

Question 5

Fetal presentation

Answer 5

Fetal part over the pelvic inlet (96% cephalic, 3.5% breech and 0.4% shoulder or back)

Question 6

What are the different types of breech deliveries?

Answer 6

*

Question 7

How do you diagnose fetal presentation in physical exam?

Answer 7

Leopold’s maneuvers (feel from the pelvic inlet up to the fundus)

Question 8

Fetal lie

Answer 8

Relation of the long axis of the fetus to the long axis of the mother: Longitudinal fetal lie and transverse fetal lie are shown below.

Question 9

Reference points for fetal presentation

Answer 9

Occiput, mentum and sacrum.

Question 10

Difference between false and true labor?

Answer 10

Fase = irregular contractions without cervical dilation and discomfort relieved by sedation. True = regular contractions with cervical dilation and pain not relieved by sedation.

Question 11

Stages of labor

Answer 11

1st (latent phase = starts dilating to 6cm, active phase = 6cm to pushing) 2nd = pushing to delivery. 3rd = delivery of placenta.

Question 12

What happens to the cervix during labor?

Answer 12

Softening, dilation, effacement, station, consistency and position.

Question 13

When is the baby’s head engaged?

Answer 13

0 station = equal with ischial spines

Question 14

7 cardinal movements of labor

Answer 14

Fetal movements that the mother can’t do: engagement, descent, flexion, internal rotation, extension, external oration and expulsion.

Question 15

3 essential factors of labor

Answer 15

3 P’s: Passage, Power and Passenger

Question 16

What are signs of placental separation

Answer 16

Uterine contraction, gush of blood and lengthening of umbilical cord

Question 17

Normal labor progression in the active phase of the first stage of labor

Answer 17

Nulliparous =1cm/hr. Multiparous = 2c/hr.

Question 18

Normal labor progression in the second stage of labor

Answer 18

Nulliparous 1-2 hrs w/no epidural, 2-3 hrs with. Multiparous 0-1 hrs w/no epidural and 1-2 hours with.

Question 19

At what point of the active phase of labor do you consider other options due to arrest?

Answer 19

Arrest of dilation > 6 hrs. Consider oxytocin or C-section.

Question 20

Arrest of descent

Answer 20

Child gets stuck in vaginal canal.

Question 21

Risk for vacuum delivery

Answer 21

Subgaleal hemorrhage

Question 22

Indications for C-section

Answer 22

Prior c-section, non reassuring fetal tracing, placenta previa, noncephalic presentation, arrest disorder, pelvic floor dysfunction or elective