labor and delivery

Question 1

breech presentation

Answer 1

developmental dysplasia of the hip, torticollis, mild deformations

Question 2

shoulder dystocia

Answer 2

macrosomic infants of diabetics, post-term pregnancy, multiparity, prolonged second stage of labor, forceps delivery, maternal obesity, AMA, epidural anesthesia

Question 3

PROM

Answer 3

STIs, smoking, prior preterm delivery, multiple gestations

Question 4

PROM v PPROM

Answer 4

PROM: after 37 weeks, prior to labor
PPROM: prior to 37 weeks

Question 5

preterm labor

Answer 5

BIG: multiple gestations, prior preterm birth

little: *prior cervical procedures, <17 or >35
*lower educational level, lower SES, single marital status, poor access to healthcare, interpersonal violence
*type I DM, HTN, thyroid disease, asthma, kidney insufficiency, anemia, MDD, autoimmune disorders
*infections – gonorrhea, chlamydia, BV, trich, syphilis, UTI, pyelonephritis, endometritis
*alcohol, cocaine, heroin, tobacco
*short cervical length btwn. 14-28wks, + fetal fibronectin at 22 & 34wks, uterine contractions, vaginal bleeding, placenta previa, placental abruption, polyhydramnios, oligohydramnios, fetal anomaly, assisted reproductive conception

Question 6

prolapsed umbilical cord

Answer 6

low birth weight, #1 malpresentation, long umbilical cord, pelvic deformities, low-lying placentation, polyhydramnios, prematurity

Question 7

endometritis

Answer 7

*C-SECTION BIGGEST RISK FACTOR
*prolonged rupture of membranes >24hrs, vaginal delivery, D&C (or evacuation), multiple pelvic examinations
*chorioamnionitis (fetal membrane infection)

Question 8

PPH

Answer 8

rapid or prolonged labor, overdistended uterus, C-section, anesthesia, retained placenta

Question 9

postterm pregnancy

Answer 9

primigravid, prior postterm pregnancy, maternal obesity, older maternal age, male fetal gender, certain congenital conditions (adrenal gland hypoplasia, congenital adrenal hyperplasia, placental sulfatase deficiency)