Labor & Delivery Flashcards
Name the four Leopold Maneuvers?
- Fundal Grip
- Umbilical grip
- Pawlick Grip
- Pelvic Grip
Which pelvic shape has the narrowest inlet transverse diameter?
Anthropoid
(ENTRYPOID - Inlet)
Which pelvic shape has the narrowest outlet transverse diameter?
Android
This is the shortest distance between sacral promontory and symphysis pubis. What is the usual measurement of this distance?
Obstetrical Conjugate , >/= 10cm
What is the Bishop Score requirement for a cervix that is favorable for spontaneous and induced labor?
> 8
What is the Bishop score of a woman whose cervix is 2cm dilated , 50 to 50% Effaced, Fetus is station -2 , cervix located at midposition, and of medium consistency?
Bishop Score 5
Mnemonic : DESPC-ito
Dilatation (Odd) : Closed , 1,3, >/=5
Effacement: (Even) : 0, 40, 70, >/=80
Station: -3,-2, -1, >/= +1
Position: Post, Mid, Ant
Consistency: Firm, Medium, Soft, ( Forehead, Nose, Lips)
What is the reference point in face presentation?
Mentum
What is the reference point in shoulder presentation?
Acromion
This occurs when the sagittal suture approaches sacral promontory?
Anterior asynclitism
What is the definition of premature rupture of membranes? (ROM)
Rupture before onset of labor
What is the definition of prolonged premature rupture of membranes? prolonged ROM?
More than 18 hrs ROM
What is the definition of preterm premature rupture of membranes? (PPROM)
<37 weeks aog
Which interventions are used in the augmentation of labor?
Oxytocin & Amniotomy
What is the normal baseline heart rate in fetal heart tracing?
110-160bpm
What is the definition of absent, minimal, moderate, and marked variability?
Absent: < 3 beats per min of variation
Minimal: 3-5 bpm of variation
Moderate: 5-25 bpm
Marked: >25 bpm
What are the functional divisions of labor? (3)
Preparatory Division
Dilatational Division
Pelvic Division
What are the phases of cervical dilatation? (2)
- Latent Phase
- Active Phase
- Acceleration Phase
- Phase of Maximum Slope
- Deceleration Phase
What are the stages of labor?
1st Stage : stage of cervical effacement and dilatation
2nd Stage: Stage of fetal expulsion
3rd Stage : Placental separation and expulsion
Name the 3 P’s of the Active Phase?
Power
Passenger
Pelvis
What are the cardinal movements of labor?
ED FIRE ERE
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation
Expulsion
What are the 3 signs of placental separation?
- Cord lengthening
- Gush of blood
- Uterine fundal rebound
What constitutes the second-degree perineal laceration?
Laceration extends into the perineal body and spares the anal canal sphincter
Most dreaded complication in an uncorrected transverse lie?
Uterine rupture
Factor that may cause prolonged occiput transverse presentation?
Epidural analgesia
Which is the most common site of laceration after labor and delivery ?
Perineum
Degree of laceration involving internal anal sphincter but not the rectal mucosa?
Third degree laceration ( IIIC )
What antibiotic will you give as a single dose at the time of repair of a fourth degree laceration?
2 nd gen Cephalosporins or Clindamycin for penicillin allergic women
Shortest AP diameter of the pelvic inlet ?
Obstetric conjugate
Pelvis type that has <12 cm transverse diameter inlet ?
Anthropoid
Presentation if a fetal extremity presents along side the vertex or breech?
Compound extremity / presentation
Percentage of term pregnancies complicated by PROM that will go into spontaneous labor in the absence of obstetric intervention?
- 50% within 12 hrs +20
- 70% within 24hrs +15
- 85% within 48 hrs +10
- 95% within 72 hrs
What is the proposed pathophysiology of PROM?
Pathogenic bacteria causes premature release of collagenase
A 25 yo G1P0 consulted for premature contractions which persist even after resting. However, she never had any previous prenatal check ups with you. On physical exam, her fundic height with fetal heart tone of 145bpm at the left quadrant. LMP based aog is 27-28wks . What is the best tool to rule out growth retardation?
Ultrasound with doppler
Occiput posterior presentation can lead to a higher probability of?
Cesarean Delivery
What is the relation of the fetal head to the ischial spines of the female pelvis?
Engagement
What is the purpose of flexion in labor?
Allows the smallest diameter of the fetal head to pass the ischial spines.
Identify Leopolds Manuever:
Refers to the distance from the top of the uterus to the pubic bone.
Fundal grip
Identify Leopolds Manuever:
Identifies Fetal lie & Estimated Gestational Age
Fundal grip
Identify Leopolds Manuever:
Locate the fetal back
Umbilical grip
Identify Leopolds Manuever:
Determines the fetal position ( eg. breech / vertex)
Umbilical grip
Identify Leopolds Manuever:
Identify the presenting part eg. Cephalic presentation
Pawlik’s grip
Identify Leopolds Manuever:
Assess engagement by assessing location of fetal head.
Pelvic grip
