Labor and Delivery Flashcards
How is labor clinically defined?
Painful uterine contractions causing cervical effacemnet and dilation
Does walking make true labor better or worse?
Worse, will improve false labor pains
If a mom is GBS positive and not allergic to penicillins, what is the treatment regimen prior to birth?
Treat with Penicillin G for at least two doses (4 hrs apart) until delivery of the baby
What is the most common form of deceleration in FHR?
Variable decelerations are associated with cord compression which show an abrupt decrease
Are variable decels normal?
Yes, about 86% of pregnancies will have variable decels
What pattern in decels are concerning and should be acted on?
Late decelerations, that are persistent and associated with a decreased beat to beat variability
Variable, late, and prolonged decelerations are indicative of what?
Disruption of oxygen transfer
How is uterine contraction strength measured?
Montevideo units (MVU)
What is a Montevideo unit (MVU)?
Sum of the intensity of each CTX in 10 minutes, > 200 MVU’s indicate adequate uterine activity
What is the presentation of cord prolapse?
Umbilical cord falls between presenting part and cervix with or without membrane rupture
What is the immediate next step after discovery of a cord prolapse?
Immediate delivery by c-section
What is an ideal intrauterine pressure to conduct a good contraction?
50-60mmHg
A Bishop score of < 6 is indicative of what intervention?
Cervical ripening is recommended before the induction of labor
What events define Stage 1 of labor?
From beginning of labor until full cervical dilation (10 cm)
How long does Stage 1 of labor typically last?
10 hours on average
What are the labor phases of Stage 1 of labor?
Latent Phase
Active Phase
Transition (deceleration phase)
What are the labor phases included in Stage 2 of labor?
Lull (complete dilation until urge to push)
Active bearing down
Perineal (crowning)
What are the signs of the 3rd stage of labor?
Gush of blood
Cord appears to lengthen
Uterus becomes globular
Uterus rises anteriorly
What is included in active management in the third stage of labor?
- Administration of uterotonic (oxytocin) soon after delivery of anterior shoulder
- Application of fundal pressure after delivery of placenta
- Controlled traction on umbilical cord
A women with severe risk factors for gestational diabetes should be screened when?
As soon as possible
When should a women with limited risk factors be screened for gestational diabetes?
Between 24 and 28 weeks gestation
What is the recommended imaging modality for the first trimester?
TVUS
Structures that should be visualized during this exam include the gestational sac, embryo, ovaries, yolk sac, CRL, and fetal heart rate
How should progression of labor be tracked?
The progress is best evaluated by assessing cervical dilation, descent, and position and should be recorded on a labor graph to detect obvious deviations from a normal course.
The most common cause of postpartum hemorrhage is
Uterine atony
In a complete breech presentation, the fetus’ presents
Hips and knees are flexed
During oocyte formation in the ovary, there are various stages that the oocyte must go through in order to be ready for ovulation and subsequent fertilization. What is the term used for a mature follicle on the ovary which contains the oocyte that is ready for ovulation?
Graffian Follicle
Graafian follicles contain several layers of cells which make up the follicle. What is the outer most layer which provides connective tissue support?
Theca externa
Prolactin causes milk synthesis. Suckling stimulus causes release of prolactin and maintains synthesis and release of prolactin. What parameter does the suckling stimulus inhibit with respect to cyclicity?
GnRH
Approximately how long does the ova live after being extruded from the ovary?
12 to 24 hours
