Intrapartum

Question 1

What is a nitrazine test used for?

Answer 1

To confirm ROM

Question 2

What is the greatest risk factor for third- or fourth-degree lacerations during vaginal delivery?

Answer 2

medial episiotomy

Question 3

What is the best way to minimize the risk of extensive damage to the perineum?

Answer 3

avoidance of episiotomy

Question 4

How is prolonged latent phase defined?

Answer 4

> 20 hrs for nulliparas

>14 hours for multiparas

Question 5

What is amniotomy?

Answer 5

artificial rupture of membranes

Question 6

What are risks for cord prolapse?

Answer 6

rupture of amniotic membranes, polyhydramnios, small fetus, backup transverse lie

Question 7

What is McRoberts maneuver used for?

Answer 7

In case of shoulder dystocia

Question 8

What is the “turtle sign” and when is it seen?

Answer 8

retraction of the fetal head seen when the anterior shoulder catches, shoulder dystocia

Question 9

What are risk factors for placental abruption?

Answer 9

smoking, cocaine use, chronic HTN, trauma, prolonged premature rupture of membranes, hx of prior abruptions

Question 10

What are common presenting signs of placental abruption?

Answer 10

abdominal pain, bleeding, uterine hypertonus, fetal distress

Question 11

What are prostaglandin E1 and E2 used for?

Answer 11

Increase the rate of contractions

Question 12

What is the appropriate management of a suspected intra-amniotic infection?

Answer 12

Delivery

Question 13

Magnesium sulfate is contraindicated in what patient population?

Answer 13

myasthenia gravis

Question 14

What is the first sign of magnesium toxicity?

Answer 14

diminished/absent DTR

Question 15

What is associated with betamethasone treatment between 24 and 34 weeks?

Answer 15

increase pulm maturity, decrease intracerebral hemorrhage, decrease necrotizing enterocolitis

Question 16

What is the strength of fetal fibronectin?

Answer 16

negative predictive value 99.2%

Question 17

What is the mechanism of action of magnesium sulfate?

Answer 17

completes with calcium for entry into cells

Question 18

When are prostaglandins contraindincated during labor?

Answer 18

For pts with h/o previous cesarean delivery

Question 19

When is fetal heart rate considered “tachycardia”?

Answer 19

> 160

Question 20

What maternal conditions lead to fetal tachycardia?

Answer 20

chorioamniotnitis and maternal fever

Question 21

How is a variable deceleration characterized?

Answer 21

sharp decrease in heart rate with a slow /variable rise back to baseline

Question 22

What is the objective of the left lateral position?

Answer 22

increases perfusion to the uterus, treat fetal hypoperfusion

Question 23

What is a complication of oxytocin use intrapartum?

Answer 23

insufficient uterine relaxation between contractions –> placental spiral artery constriction, decrease in placental blood flow, fetal hypoxia

Question 24

Define the stages of labor:

Answer 24

stage 1 - latent 0-6 cm dilation; active 6-10 cm dilation
stage 2 - 10 cm to delivery of baby
stage 3 - delivery of baby to placenta