Labour

Question 1

Definition of latent vs active labour

Answer 1

Transitions at 4-3 cm nilated (mullipara) or 4-5 cm dilated (multipara)

Question 2

Definition of dystocia

Answer 2

<2 cm in 4hrs or 2 hours with 0 cm

Question 3

Causes of dystocia

Answer 3

Power
Passage
Passenger
Psyche

Question 4

How to monitor in active phase of first stage

Answer 4

Intermittent EFM

Question 5

List three non pharm and three pharm pain relief for the first stage

Answer 5

Hypnosis
Acupuncture
Water immersion
TENS

Nitrous oxide
Opiouds (not demerol)
Pudendal nerve block
Epidural

Question 6

How to monitor in the 2nd stage

Answer 6

Continuous or q 5 min fetal monitoring

Monitor head descent, can wait up to 2 hours to start pushing

Question 7

Dystocia in second stage

Answer 7

Nulliparous no epidural >3 hrs
Nulliparous epidural >4 hrs
Parous no epidural >2 hrs
Parous with epidural >3 hrs

Question 8

List five steps of management of the third stage

Answer 8

Oxytocin IM
Delayed cord clamping (1 minute
controlled cord traction

Question 9

GBS management

Answer 9

Screen 35-37 weeks
IV penicillin
Cefazolin of pen allergy

Give at start of labour

Question 10

Risks of induction of labour

Answer 10

Uterine rupture
Cord prolpase
Abnormal FHR
Risk of operative vag delivery or c section

Question 11

Contraindications for vaginal delivery

Answer 11

Previous uterine rupture
Transverse lie
Placenta pravia 
Cervical cancer
Active genital herpes

Question 12

What is the bishop score

Answer 12

Dilation, effacement, station, conssitency, position

Can do cervical ripening with catheter PGE prepidil if <6
Do not use PGE if vbac

If >6 can use oxytocin

Question 13

Risks of oxytocin

Answer 13

Uterine rupture
Hypotension
Overcontractility

Question 14

What to do it too much uterine activity on oxytocin

Answer 14

Reposition
IV fluids
O2
Discontineu Oxytocin

Question 15

Concering in fetal heart rate

Answer 15

> 60 seconds
60 below baseline
<60 bpm
Overshooting back past baseline

Question 16

How to deal with concerning tracing

Answer 16

LLD position 
O2
Stop oxytocin 
Fluids
Fetal scalp monitor 
Cs

Question 17

Risks for placental abruption

Answer 17

Prvious
Htn 
Smoking 
Etoh
Multiparity 
PPROM 
Fibroids 
Trauma

Question 18

Placental abruption presentation and treatment

Answer 18

Painful baginal bleeding 
Get CBC, Type and screen, fibrinogen 
IVF, O2, montior 
Blood produtcs 
Rhogam if necessary 
CS

Question 19

Signs of uterine rupture

Answer 19

Abdo pain
Bleeding
Palpable parts

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