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#DAY4_OBSTETRICS/GYNECOLOGY > Labor And Delivery; Anesthesia > Flashcards

Labor And Delivery; Anesthesia Flashcards

1
Q

Quantifiable method used to predict labor induction outcomes

A

Bishop score

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2
Q

Bishop score components

A

SPCED Station Position Consistency Effacement Dilation

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3
Q

Safest drug for induction

A

Oxytocin

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4
Q

What term is used when the anterior fontanel is the presenting part?

A

Sinciput

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5
Q

Rate of cervical dilatation in nullipara and multipara

A

Nullipara-1.2 cm per hour Multipara- 1.5 cm per hour

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6
Q

Prolonged latent phase in nullipara

A

20 hrs

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7
Q

Prolonged latent phase in multipara

A

14 hours

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8
Q

Postion of fetus upon entering the maternal pelvis

A

LOT

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9
Q

Greatest transverse diameter in an occiput presentation

A

Biparietal diameter

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10
Q

Pelvic inlet corresponds to this structure

A

Linea terminalis

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11
Q

Lateral deflection of the saggital suture either posteriorly toward the promontory or anteriorly toward the symphysis

A

Asynclitism

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12
Q

The linea terminalis consists of 3 structures

A

Pubic crest Pectineal line Arcuate line

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13
Q

Promontory to upper margin of symphysis is what diameter

A

True/Anatomic conjugate

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14
Q

True conjugate measures

A

11cm

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15
Q

Promontory to the posterior symphysis is what diameter

A

Obstetric conjugate

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16
Q

The obstetric conjugate is measured by

A

Subtract 1.5-2 cm from diagonal conjugate

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17
Q

Obstetric conjugate is normally

A

>10cm

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18
Q

The only conjugate that is measured manually

A

Diagonal conjugate

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19
Q

Diameter that is from the promontory to the lower margin of the symphysis

A

Diagonal conjugate

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20
Q

What is the normal value of the diagonal conjugate

A

11.5cm

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21
Q

This diameter measures the greatest diameter between the linea terminalis

A

Transverse conjugate

22
Q

Normal transverse conjugate

A

13cm

23
Q

First requisite for birth of the newborn

A

Descent

24
Q

Cardinal movement that is essential for the completion of labor

A

Internal rotation

25
Q

The goal of the third stage of labor is

A

Prevent uterine inversion

26
Q

Signs of placental separation

A

Globular fundus Sudden gush of blood Lengthening of cord Rise of uterus in the abdomen

27
Q

Perineal laceration up to the perineal body

A

2nd degree

28
Q

Perineal laceration up to the anal sphincter

A

3rd degree

29
Q

Perineal laceration up to the rectal mucosa

A

4th degree

30
Q

Must give oxytocin 10 units IM after the delivery of

A

Anterior shoulder

31
Q

Indication of operative vaginal delivery includes

A

Prolonged second stage

32
Q

Forceps is properly handled by

A

Pencil grip Vertical insertion Right thumb directing

33
Q

Engagement and descent of breech include that the _____ diameter is in the oblique diameter

A

Bitrochanteric

34
Q

Does the anterior or posterior hip descend more rapidly in breech?

A

Anterior

35
Q

Frank breech decomposition is also called this maneuver

A

Pinard

36
Q

Breech extraction where both feet are grasped through the vagina

A

Complete breech extraction

37
Q

In partial breech extraction, the fetus is allowed to spontaneously deliver up to the level of the

A

Umbilicus

38
Q

Incision on the cervix at 2 and 10 o clock position to minimize bleeding from the uterine artery branches

A

Dührssen incision

39
Q

Delivery of the aftercoming head is done through this maneuver

A

Mauriceau

40
Q

What is the direct cause of most maternal deaths involving regional anesthesia

A

High spinal blockade

41
Q

What anesthetic is associated with neurotoxicity and cardiotoxicity in the same serum levels?

A

Bupivacaine

42
Q

What is the most common complication encountered during epidural anesthesia?

A

Hypotension

43
Q

Bichop scoring

A
44
Q

LABOR: CRITERIA FOR DIAGNOSIS

A
  • Uterine contractions (1 in 10 mins; 4 in 20 mins) by direct observation or by electronic fetal monitor.
  • At least 200 Montevideo units (MVU)
  • Documented progressive changes in cervical dilatation & effacement
  • Cervical effacement of >70-80%.
  • Cervical dilatation >3 cm.
45
Q

INDICATIONS FOR INDUCTION OF LABOR

A
  • Gestational hypertension
  • Preeclampsia, eclampsia
  • Prelabor rupture of membranes (PROM)
  • Maternal medical conditions (e.g. DM, renal disease, infertility, APAS)
  • Gestation > 41 1/7 weeks
  • Fetal compromise (e.g. FGR)
  • Fetal demise
  • Logistic factors for term pregnancy (e.g. history or rapid labor, proximity from hospital, psychosocial indications)
  • Intraamniotic infection
46
Q

CONTRAINDICATIONS FOR INDUCTION OF LABOR

A
  • Malpresentation (e.g. breech)
  • Absolute cephalo-pelvic disproportion
  • Placenta previa
  • Previous major uterine surgery (e.g. classical CS, myomectomy)
  • Invasive carcinoma of cervix
  • Cord presentation
  • Active genital herpes
  • Gynecological, obstetrical, or medical conditions that preclude vaginal birth
  • Physician’s convenience
47
Q

Signs of uterine hyperstimulation

A

§ Five (5) contractions in 10 minutes or more than 10 contractions in 20 minutes.

§ Hypertonus – contraction(s) lasting more than 120 seconds

§ Excessive uterine activity with an atypical or abnormal fetal heart rate.

48
Q

3 functional divisions of labor.

A
  • Preparatory division – the cervix dilates little, but the connective tissue components change considerably. Sedation and conduction analgesia are capable of arresting this division.
  • Dilatational division – dilation proceeds at its most rapid rate; unaffected by sedation
  • Pelvic division – commences with the deceleration phase of cervical dilatation. The classic labor mechanisms that involve the cardinal fetal movements of the cephalic presentation takes place principally in this division.
49
Q

Sagittal suture approaches the sacral promontory, more of the anterior parietal bone presents itself to the examining fingers.

A

o Anterior asynclitism

50
Q

Sagittal suture lies close to the symphysis, more of the posterior parietal bone will present.

A

o Posterior asynclitism

#DAY4_OBSTETRICS/GYNECOLOGY (22 decks)

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