Labor and Delivery

Question 1

What are the premonitory signs of labor?

Answer 1

1. Lightening
2. Braxton Hicks
3. Cervical changes
4. Bloody Show
5. Rupture of the membrane
6. Sudden Burst of Energy

Question 2

What are the probably causes of Labor?

Answer 2

1. Progesterone Withdrawal Hypothesis (decreases muscle relaxation)
2. Prostaglandin Hypothesis (oxytocin indirectly stimulates prostaglandin production)
3. Corticotropin releasing hormone

Question 3

How long should contractions be by the second stage of labor?

Answer 3

60-90secs

Question 4

How frequent should contractions be by the second stage of labor?

Answer 4

Once every 1-1/2 mins

Question 5

What are some signs of true contraction?

Answer 5

Occur at regular intervals

Frequency increases

Intensity increases

Pain radiates from back to abdomen, increases while walking

Cervical dilation and effacement are progressive

Question 6

What are the Cardinal Movements during labor?

Answer 6

1. Descent
2. Flexion
3. Internal Rotation
4. Extension
5. Restitution
6. External rotation
7. Expulsion

Question 7

What are the three breathing patterns?

Answer 7

1. slow-paced breathing (6-9breaths a minute)
2. Shallow or modified breathing (4 breaths every 5 seconds)
3. Pant blow or patterned-paced breathing ( all breaths kept equal and patterned

p. 423

Question 8

What are the signs and symptoms of hyperventilation?

Answer 8

Tingling or numbness at the tip of the nose, lips, figners or toes; dizziness, spots before eyes and spasms of the hands and feet.

Question 9

What are the four pelvic types in women?

Answer 9

1. Gynecoid (Inlet, midpelvis and outlet are all adequate)
2. Android (all reduced)
3. Anthropoid (inlet oval shaped, midpelvis and outlet adequate)
4. Platypoid (inlet oval, midpelvis reduced, outlet inadequate)

Question 10

What should be done before performing the Leopald’s maneuvers?

Answer 10

Get the patient to empty their bladder

Question 11

What are some indications for Electric Fetal monitoring?

Answer 11

Previous history of a stillborn
Presence of a complication of pregnancy
Induction of labor
Preterm labor
Decreased fetal movement
Meconium

Question 12

What are some causes of decreased variability in FHR?

Answer 12

Hypoxia and acidosis
Drugs that depress the fetal central nervous system
Decreased sleep cycles
Fetus less than 32 weeks gestation
Tachycardia

Question 13

What are the different types of fetal decelerations?

Answer 13

Early deceleration (benign, happens before contractions)
Late decelerations (caused by maternal hypotension due to epidurals and anesthesia)
Variable decelerations (umbilical cord becomes compressed)

Question 14

When does late post partal hemorrhaging usually occur?

Answer 14

24h to 6 weeks after birth.

Question 15

What are the 3 main causes of PPH?

Answer 15

1. Uterine atony
2. Lacerations
3. Hematomas

Question 16

What is a drug that can be used to prevent uterine atony?

Answer 16

Oxytocin, ergotamine and prostaglandin

Question 17

What is a major cause of late PPH?

Answer 17

Subninvolution, whereby the uterus fails to return to normal size.May be a result of retained placental tissue of infection.

Lochia that remains rubra after 2 weeks is highly indicative of subinvolution.