Labor and Delivery

Question 1

What are the stages of labor?

Answer 1

1 = onset of full labor to full dilation of cervix (10cm), can either be latent (ear dilation) or active (usually beginning at 3-4cm)

2 = complete cervical dilation (10cm) through delivery to infant

3 = After delivery, ends with delivery of the placenta

Question 2

What is the problem with a rupture of the chorioamniotic membrane before the onset of labor? What do you do?

Answer 2

Increased risk of infection and baby born early

Monitor for infections (including a sterile speculum exam) and delivery to avoid infection is best

Question 3

What is the difference between Pitocin and Oxytocin?

Answer 3

Oxytocin is natural occurring hormone that initiates labor and effects mood throughout pregnancy

Pitocin is a synthetic hormone that mimics oxytocin to initiate labor

Question 4

If a neonate is facing butt first, what is it called?

Answer 4

Breech position

Question 5

What is dystocia? What are the 3 categories of dystocia?

Answer 5

Dystocia = difficult or abnormal progression of labor

Power = problem with contractions

Passenger = baby’s position/size

Passage = pelvis and soft tissues

Question 6

how do you treat dystocia?

Answer 6

If pt has been in stage 1 for more than 14 hours – give Pitocin

If pt has been in stage 2 for more than 2 hours – C-section of oxytocin

Question 7

What happens if stage 3 is not complete and there is a retained placenta?

Answer 7

Dangerous for infection and post labor bleeding

Question 8

What should you think of if you see post-partum fever?

Answer 8

Retained placenta

Question 9

What is the MC cause of postpartum hemorrhage? How do you treat?

Answer 9

Uterine atony (failure to produce coagulopathies)

Tx = uterine massage, blood transfusions, hysterectomy

Question 10

What are the risk factors to postpartum hemorrhage?

Answer 10

Prolonged or rapid labor, distended uterus

Question 11

What is the baby’s first poop known as?

Answer 11

Meconium

Question 12

How do we treat post-partum depression?

Answer 12

SSRIs, support, and therapy

Question 13

What are the trimesters of pregnancy?

Answer 13

First = 1-12

Second = 13-35

Third = 26 – delivery (40)

Question 14

Should a pt take vitamin A during pregnancy?

Answer 14

NO, increased risk of birth defects

Question 15

If a pt has pruritic, urticarial papules and plaques during pregnancy all over the body – what is it?

Answer 15

PUPPS rash