labor and delviery

Question 1

1st day of the last LMP=

Answer 1

gestational age

Question 2

stages of labor

Answer 2

cervical
expulsion
placental

Question 3

cervical stage starts with ____ ends with____

Answer 3

starts with labor ends with dilation of the cervix

Question 4

expulsion stage requires mom to push and ends with

Answer 4

delivery of baby

Question 5

placental stage

Answer 5

begins with delivery of baby ends with delivery of the placenta 5-10 minutes

Question 6

Cardinal movements of baby during labor

Answer 6

engagement
descent
flexion at the neck
Internal rotation neck
extension at the neck
external rotation at the neck
expulsion

Question 7

Dystocia

Answer 7

labor that doesn’t progress as expected

Protraction (cervix isn’t dilating fast or baby isn’t descending fast enough) or

arrest (dilatataion and descent stops)

Question 8

emergent complications

Answer 8

cord prolapse and shoulder dystocia

Question 9

causes or dystocia power tx:

Answer 9

uterine isn’t contracting fast engough

oxytocin

Question 10

passenger dystocia caused by

Answer 10

macrosomia

Question 11

passage dystocia caused by

Answer 11

birth canal (true pelvis)

Question 12

plus station=

Answer 12

head by the ischial spines

Question 13

issues with pelvis related to dystocia

Answer 13

pelvic inlet (anterior to posterior of pelvic inlet) (obstetric conjugate)

sacral contour

bony prominences

Question 14

how do you approximate the obstetric conjugate?

Answer 14

measure the diagonal conjugate transvaginally
finger hits the sacral promontory and pubic symphisis distance

this overestimates distance

Question 15

ideal pelvic type?

Answer 15

gynecoid

Question 16

Which pelvic type poses a good amount of issues because of the narrowing of the pubic arch?

Answer 16

android

arrest of descent

Question 17

anthropoid is wider where?

Answer 17

front to back.

enter looking forward or back (looking up at the pubic bone)

issues?
arrest of descent or persistent occiput posterior

Question 18

issue with flat/platepelloid

Answer 18

wider side to side and baby can rotate

Question 19

Cord prolapse types

Answer 19

funic presentation

occult prolapse

overt prolapse

Question 20

Which cord prolapse is most common and what is it?

Answer 20

overt prolapse, umbilical cord is descending down through cervix

seen a lot in AROM (induced water breaking)

Question 21

Breeches

Answer 21

Frank
Complete
Footling

Question 22

which breech predisposes to cord prolapse

Answer 22

Footling

Question 23

what do you do if you break the water and you feel a cord prolapse?

Answer 23

keep exam hand in the uterus to hold baby up off the cord

call for help prep for C section

Question 24

manipulating cord risk of?

Answer 24

vasospasm

Question 25

shoulder dystocia

Answer 25

shoulders trapped behind pelvis

risk of asphyxia
maternal hemrhg

Question 26

risks of shoulder dystocia

Answer 26

macrosomia, maternal diabetes, obesity, post term gestation, previous history of macrosomia

Question 27

turtle sign?

Answer 27

head pops back up…..possible shoulder dsytocia

Question 28

mgmt of shoulder dystrocia

Answer 28

knees up to chest (mcroberts)

suprapubic pressure

deliver posterior arm of the fetus

corkscrew maneuvers

fracture fetal clavical

NO FUNDUS PRESSURE

Question 29

brachial plexus injuries ca cause from shoulder dystocia

Answer 29

erbs palsy

Question 30

midline episiotmy

Answer 30

less pain, ease of repair less blood loss

BAD: anal sphincter loss