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Medicine II: OBGYN > Labor, Delivery and Anesthesia > Flashcards

Labor, Delivery and Anesthesia Flashcards

1
Q

What are the stages of delivery

A
  1. onset of contractions until fully dilated
  2. From full dilation until delivery
  3. From delivery of the baby until delivery of placenta
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2
Q

What are the stages within the first stage?

A

latent and active

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3
Q

What is a prolonged latent phase?

A

> 20 hrs in a nulliparous patient
14 hrs in a multiparous patient

not dilating

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4
Q

What is a protracted active phase?

A

rate of dilation in active phase <1.2 cm/hr in a nulliparous patient

rate of dilation in active phase is less than 1.5 cm/hr in a multiparous patient

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5
Q

What is an arrest of dilation

A

active phase of labor

no change in dilation over a period of two hours

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6
Q

what is a protraction-arrest disorder?

A

protracted active phase

subsequent arrest of dilation

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7
Q

during the second stage of labor what is the mean duration without epidural?

A

nullipara- 60 min

multipara- 20 min

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8
Q

during the second stage of labor what is the mean duration with epidural?

A

nullipara 90-120 min

multipara 40-60 min

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9
Q

What is a protracted descent?

A

2nd stage > 2hr in a nullipara

2nd stage >1hr in a multipara

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10
Q

What is an arrest of descent?

A

no change in station over a period of 1 hr

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11
Q

What are causes of abnormal labor?

A 
poor uterine contractility
over sedation
intrauterine infection
malpresentation
malposition
fetopelvic disproportion
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12
Q

How do you manage abnormal labor?

A 
evaluate fetal presentation
evaluate fetal position
evaluate uterine contractility
evaluate maternal pelvis
Treat maternal infection if present
preform amniotomy
administer oxytocin
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13
Q

What is the optimal anesthetic for both labor and delivery?

A

Epidural

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14
Q

What anesthetic do you give for an emergency cesarian?

A

general

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15
Q

What anesthetic do you give for an operational vaginal or cesarian delivery?

A

spinal

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16
Q

Episiotomy

A

Should only be preformed in selected cases where the perineum fails to distend and delivery is obstructed.
midline episiotomy is preferred

17
Q

What are the most common indications for cesarean delivery?

A 
dystocia
repeat
distress
bleeding
malpresentation
18
Q

What is the most common intraoperative complication with a cesarean delivery?

A

hemorrhage- <2% in scheduled

19
Q

What is the most common postoperative complication with a cesarean delivery?

A

infection, specifically endometritis: 10% in emergency c/s, 5% in scheduled

20
Q

What is the preferred incision for a cesarean section?

A

low transverse, Kerr

21
Q

Why would a woman have a chance of getting a UTI during child birth?

A

catheter

22
Q

What do you do if the mothers membrane is not broken and she is having contractions?

A

break her water and give patosin

Medicine II: OBGYN (18 decks)

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