Midterm Points

Question 1

What is a uterine rupture?

Answer 1

It occurs when a weakened spot on your uterine wall tears due to strain put on it during labor and delivery.

Question 2

What are the 5 symptoms of uterine rupture?

Answer 2

Abdominal pain
Vaginal bleeding 
High pulse rate 
Signs of shock 
Chest pain

Question 3

What is the most significant risk factor of uterine rupture?

Answer 3

A scar from a previous cesarean delivery

Question 4

Assessment of complete uterine rupture?

Answer 4

Severe abdominal pain
Halt in contractions
Absent of FHR 
possible vaginal bleeding 
Falling blood pressure 
Rapid, weak pulse

Question 5

What is uterine inversion??

Answer 5

Refers to the uterus’s turning inside out with either birth of the fetus or delivery of the placenta

It occurs when the placenta fails to detach from the uterus as it exits, pulls on the inside surface, and turns the organ inside out.

Question 6

What happens when an inversion occurs??

Answer 6

• Loss of great amount of blood in the vagina

- fund us is not palpable in the abdomen

Question 7

Risk factors of uterine inversion?

Answer 7

Fundal implantation or abnormal adherence of the placenta
Weakness of the uterus musculature or other uterine abnormalities
Excess traction on the umbilical cord or vigorous manual removal of the placenta

Question 7

Nursing intervention of uterine inversion??

Answer 7

• Do not attempt to replace an inversion may enhance bleeding
• Do not remove placenta if it is still attached : larger surface area for bleeding
• no admin of oxytocin drug thus makes the it uterus more intense
• IVF starts
• oxygen starts by masks and asses v/s
• CPR if needed
• general anesthesia to relax muscles
• replaces the fundus manually
• admin of oxytocin after manual helps the uterus to contract
• advise of future cesarean birth

Question 8

What are the 3 variations of uterine rupture??

Answer 8

A- complete rupture
B- incomplete rupture
C- dehiscence

Question 9

What is a complete uterine rupture?

Answer 9

It is a rupture that is going through the endometrium, myometrium, and peritoneum

Question 10

What is an incomplete uterine rupture??

Answer 10

A rupture into the peritoneum covering the uterus or into the ligament but no the peritoneal cavity

Question 11

What is dehiscence?

Answer 11

A partial separation of an old uterine scar with little or no bleeding

No s/s may exist and the rupture window may be found incidentally during a subsequent CS birth or other abdominal surgery

Question 12

What are the 5 complications associate with uterine rupture?

Answer 12

Depends on how quickly the doctor discovers the s/s
Maternal blood loss
Loss of placental function
Loss of oxygen of the mother and the baby

Question 13

Why is there a chest pain, pain the scapula, or pain during inhalation during uterine rupture?

Answer 13

Pain is due to the irritation of blood below the woman’s diaphragm

Question 14

What is the cause of hypovolemic shock in uterine rupture??

Answer 14

Hemorrhage

Question 15

What are the 4 predisposing factors of uterine inversion??

Answer 15

Pulling on the umbilical cord before the placenta detaches from the uterine wall (vigorous manual removal of the placenta)

Fundal pressure during birth

Fundal implantation or abnormal adherence of the placenta

Weakness of the uterine musculature or other uterine abnormalities

Question 16

What are the signs and symptoms of uterine inversion?

Answer 16

Uterus is absent from the abdomen or a depression in the fundal area is present

Interior of the uterus may be seen through the cervix or protruding into the vagina

Massive hemorrhage, shock, and pain quickly become evident

Question 17

Therapeutic management of uterine inversion?

Answer 17

Monitor for hemorrhage and signs of shock and
to threat shock, continuous IV will be needed to allow rapid fluid and blood replacement

Prepare the client for the return of the uterus to the correct position

Hysterectomy may be required: tocolytic drug or gen anesthesia

After the uterus is replaced and placenta removed, oxytocin is given to contract the uterus and control blood loss
( oxytocin is not given until the uterus is repositioned to avoid trapping the inverted fundus in the cervix)

Question 18

shapes of the pelvis?

Answer 18

Android pelvis
Anthropoid
Gynecoid
Platypelloid

Question 19

Type of pelvis in which it is flattened, reverse oval shape. A smoothly curved, but the anteroposterior diameter is shallow. Fetal head may not be able to rotate to match the curves of the pelvis.

Answer 19

Platypelloid pelvis

Question 20

A male pelvis; heart shaped. The pubic arc is in the pelvis. It forms an acute angle, making the lower dimensions of the pelvis extremely narrow. A fetus may have difficulty exiting.

Answer 20

Android pelvis

Question 21

An “ape-like pelvis” oval shape. The transverse diameter is narrow and the anteroposterior diameter of the inlet is larger than normal. It does not accommodate a fetal head.

Answer 21

Anthropoid pelvis

Question 22

A normal female pelvis round shape pelvic inlet. The inlet is well rounded forward and backward. The pubic arc is wide. Ideal for childbirth.

Answer 22

Gynecoid pelvis

Question 23

A type of labor that last less than 3 hours. It is unexpected fast delivery.

Answer 23

Precipitous labor

Question 24

What are the 3 etiology of precipitous labor?

Answer 24

Lack of resistance of maternal tissue for the passage of fetus

Intense uterine contractions

Small baby in a favorable position

Question 25

What are the nursing management of the uterine rupture?

Answer 25

Promptly removal of the unborn baby through an emergency cesarean delivery

Repairing uterine damage

Or removing the uterus completely