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OBGYN Clerkship > Labor and Delivery > Flashcards

Labor and Delivery Flashcards

1
Q

preterm vs term vs post term

A

< 37
37-42
> 42

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2
Q

what are adequate contractions

A

3-5 ctx/10 min + > 200MVU

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3
Q

What are the different “fetal lies”

A

longitudinal, transverse, oblique

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4
Q

What is fetal presentation

A

first part in vagina (cephalic/vertex vsbreech)

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5
Q

what determines fetal position?

A 
location of occiput:
                   OP
        ROP           LOP
ROT                            LOT
        ROA           LOA
                    OA
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6
Q

What is the leopoid maneuver

A

used to determine prentation, position, engagement

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7
Q

What is the MC pelvic type that also has the best px

A

gynecoid

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8
Q

what type is MC seen in asians and can lead to deep transverse arrest

A

Platypelloid

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9
Q

What are indications to induce labor

A

posterm
PROM (>34 wks)
PreE
nonreassuring fetal testing

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10
Q

What are the different methods to induce labor

A

prostaglandins (cytotec)
ocytocin (Pitocin)
amniotomy (AROM)

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11
Q

What are CI to PGE

A

amternal asthma or glaucoma, > 1 prior C/S

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12
Q

What is augmentation of labor?

A

increasing contractions in an already laboring pt

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13
Q

what is the bishop score

A

assess progresssion of labor:

  • Dilation: diameter of internal os (range 0-10 cm)
  • Effacement: thinning out of cervix (range 0-100%)
  • Station: 0 station (midpoint) is ischial spines, measure in cm above/below (range -5 to +5 cm)
  • Position: advancement of cervix as labor progresses (range posterior to anterior)
  • Consistency: softening of cervix as labor progresses (Hegar or Ladin sign)
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14
Q

Management for the following bishop scores:
0-4
5-9
10+

A 
0-4 = cytotec 
5-9 = pitocin
10+  = expectant management
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15
Q

What are the 4 stages of labor

A

1: onset to complete dilation
2: dilation to delivery
3: delivery to delivery of placenta
4: placental delivery to 2 hrs post partum

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16
Q

latent phase 1 vs active phase 1

A 
latent = 0-4 cm dilation and slow 
active = > 40 cm and fast
17
Q

What is considered active phase arrest and is an indication for C/S

A

no change in dilation or station for 2 hrs during active pahse (>4cm)

18
Q

when is stage 2 considered prolonged?

A

> 2 hrs nulliparous, > 1 hr if multiparous (add 1 hr if have epidural)

19
Q

what is the ritgen maneuver?

A

pressure on fetal head to help pass shoulders through

20
Q

When is the placenta considered to be retained? What is tx management of this?

A

stage 3 lasts greater than 30 mins

manual extraction + abx

21
Q

what are signs of placental seperation?

A

gush of blood, lengthening of cord, change in shape of uterine fundus

22
Q

If too much traction is applied to the cord, what could happen

A

cord avulsion, uterine inversion

23
Q

what is an episitomy

A

incision in perineum to facilitate delivery

2 types, median and mediolateral

24
Q

What are the cardinal movements of the fetus?

A
  1. Engagement (0 station)
  2. Flexion
  3. Descent
  4. Internal rotation
  5. Extension
  6. External rotation
  7. Expulsion
25
Q

What is an operative vaginal delivery?

A

usage of forceps or vacuum to deliver fetus

26
Q

complication with use of forceps

A

CV VII palsy

27
Q

complication with use of vacuum

A

cephalohematoma and shoulder dystocia

28
Q

what conditions are necessary for an operative vaginal delivery

A

experienced operator (most important), full dilation, ruptured membranes, engaged w/ >2 station, knowledge of fetal position, anesthesia, empty bladder, no evidence of cephalopelvic distortion

29
Q

diff btwn 1st, 2nd, 3rd, 4th degree perineal lacerations

A

1st degree: superficial tear
2nd degree: extends into perineal body
3rd degree: extends into anal sphincter
4th degree: extends into rectum

30
Q

MC reason for C/S

A

primary C/S = failure to progress in labor

overall = previous C/S

31
Q

only true CI to vaginal birth after C/S (VBAC)

A

previous vertical/classical C/S

32
Q

MC complication of TOLAC

A

rupture of uterine scar

**Rupture sx: sudden onset severe abd pain ± vaginal bleed, subjective “pop” sensation

33
Q

anesthesia indicated for operative vaginal delivery, direct needle towards jxn of ischial spine and sacrospinous ligament

A

pudental block

34
Q

anesthesia indicated for episiotomy and laceration repairs

A

local anesthesia

35
Q

epidural can lengthen stage ___ of labor

A

2

36
Q

anesthesia more commonly used during C/S

A

spinal anesthesia

OBGYN Clerkship (31 decks)

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