Midwifery, Birth and Preterm delivery

Question 1

When is a pregnancy considered post-term?

Answer 1

After 40 weeks and 10 days

Question 2

What is the total number of pregnancies a woman has had called?

Answer 2

Gravida

Question 3

What is the total number of births after 20 weeks a woman has had called?

Answer 3

Parity

Question 4

What is ‘lightening’ int terms of pregnancy?

Answer 4

When the baby drops into the pelvis and causes a change in the centre of mass for the mother?

Question 5

What hormone is responsible for exerting and inhibitory effect on the uterine smooth muscle throughout pregnancy?

Answer 5

Progesterone

Question 6

What causes uterine excitability in the final weeks of pregnancy?

Answer 6

Increased oestrogen overcoming the inhibitory effects of progesterone on smooth muscle of uterus.

Question 7

What glands in the fetus are enlarged at the end of pregnancy and why?

Answer 7

Adrenal glands of the fetus are enlarged as the rate of adrenocorticotropic hormone (ACTH) secreted by the anterior pituitary gland of the fetus greatly increases near the end of the pregnancy.

Question 8

How may the adrenal glands of the fetus induce labour?

Answer 8

Due to the increased stress inflicted upon the fetus from the confined space within the uterus and decreased oxygen supply.

• ACTH = Fetal adrenal cortex to produce glucocorticoids
• Glucocorticoids act on the placenta to decrease the rate of progesterone secretion and increase oestrogen synthesis

Question 9

Which hormone stimulates uterine contractions?

Answer 9

Oxytocin

Question 10

What hormone inhibits oxytocin and decreases oxytocin receptors?

Answer 10

Progesterone

Question 11

What hormone makes the uterus more sensitive to oxytocin and also increases uterine myometrial cells?

Answer 11

Oestrogen

Question 12

What inhibits the oxytocine positive feedback cycle during labour?

Answer 12

Catecholamines

Question 13

How long is the first stage of labour for a primip pregnancy?

Answer 13

12-14 hours

Question 14

How long is the first stage of labour for a multi pregnancy?

Answer 14

6-10 hours

Question 15

What is the machine that monitors external fetal heart rate during labour?

Answer 15

Cardiotograph

Question 16

What preceds contractions, promotes hormone response in the release of oxytocin and prostaglandins and is caused by increasing pressure in the amniotic sac?

Answer 16

Spontaneous rupture of membranes, i.e., water breaking

Question 17

What is released towards the end of pregnancy that weakens membranes and causes them to rupture?

Answer 17

Extracellular matrix-degrading enzymes - degrades collagen and fibrinonectins

Question 18

What happens to the rate and duration of contractions during second stage labour?

Answer 18

Frequency of contractions decreases while duration of contration increases.

Question 19

What state is the cervix in in second stage labour?

Answer 19

Fully dilated and incorporated into the lower uterine segment

Question 20

What occurs to the lower uterine segment during seconds stage labour?

Answer 20

Thins due to expulsive nature of contractions

Question 21

What defines the period of second stage labour?

Answer 21

Time period from fully dilated cervix to complete birth of newborn

Question 22

What are landmarks of the true pelvis that a midwife uses?

Answer 22

Brim, cavity and outlet

Question 23

How many fontanelles does a baby have?

Answer 23

4

Question 24

The fetul skull comprises of…

Answer 24

29 irregular flat bones

Question 25

How many women sustain perineal trauma in birth? (%)

Answer 25

85%

Question 26

What is the third stage of labour?

Answer 26

Birth of the newborn and expulsion of the complete placenta and membranes.

Question 27

What is the major risk in the third stage of labour?

Answer 27

Haemorrhage

Question 28

What is considered premature parturition

Answer 28

<37 Weeks gestational brith