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OB Exam 1 > Module 3: Part 1 > Flashcards

Module 3: Part 1 Flashcards

1
Q

Fewer than ____________ of pregnancies end on the expected date of delivery (EDD)

A

10%

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2
Q

Most deliveries occur within __________ of EDD

A

7 days

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3
Q

____________ births are preterm

A

13%

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4
Q

early term

A

37 to 38.6

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5
Q

full term

A

39 to 40.6

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6
Q

late term

A

41 to 41.6

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7
Q

post term

A

42 weeks +

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8
Q

what is labor

A

Physiologic process by which sufficiently frequent and strong contractions cause thinning (effacement) and dilation of the cervix, passage of fetus from uterus through the birth canal

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9
Q

uterine contractions are ____________

A

involuntary

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10
Q

3 factors that may cause labor to start via the human uterus

A

Increase in prostaglandin production

Increases in oxytocin receptors

Pacemaker cells in the middle muscle layer of the uterus that produce rhythmic coordinated contractions of labor

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11
Q

when is induction indicated

A

when the risk of continuing the pregnancy, for the mother or the fetus, exceeds the risk associated with induced labor and delivery

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12
Q

Factors associated with successful elective induction:

A

Parous patient
Singleton vertex presentation
AT least 39 weeks gestation
Favorable cervix
No contraindications to labor or vaginal delivery

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13
Q

bishop score

A

developed in 1964 as a predictor of success for an elective induction

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14
Q

bishop scoring

A

> 5 = favorable

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15
Q

cervical dilation chart

A
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16
Q

soft firmness is like

A

your lips

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17
Q

medium firmness is like

A

the inside of your cheeks

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18
Q

hard firmness

A

like the tip of your nose

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19
Q

induction delivery is indicated for

A

maternal or fetal reasons, both mother and fetus can tolerate labor and vaginal delivery

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20
Q

induction is usually for

A

medical or obstetric complications such as preeclampsia, fetal growth restriction (IUGR), post term pregnancy (Post dates) or diabetes

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21
Q

neonatal morbidities associated with early-term deliveries

A

Respiratory distress
Transient tachypnea of the newborn
Ventilator use
Pneumonia
Respiratory failure
NICU admission
Hypoglycemia
5-min Apgar less than 7
Neonatal mortality

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22
Q

indications for delivery (9)

A
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23
Q

induction of labor definition

A

The use of pharmacological and/or mechanical methods to initiate labor

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24
Q

induction of labor can be achieved via

A

Artificial rupture of membranes, Pitocin, misoprostol (cervical ripening agents)

25
Q

low vs high dose pitocin

A
25
Q

augmentation of labor; can be done with

A

The stimulation of uterine contractions to increase their frequency and/or strength following the onset of spontaneous labor

Pitocin

26
Q

Amniotic fluid provides ____________ and allows ____________

A

provides mechanical protection for the fetus and umbilical cord and allows growth and movement

27
Q

when do membranes usually rupture

A

at the onset of labor (spontaneous rupture of membranes (SROM))

28
Q

Amniotomy is

A

the procedure at which the amniotic sac is deliberately ruptured

29
Q

also called artificial rupture of membranes

A

amniotomy

30
Q

Trial of Labor after Cesarean Delivery (TOLAC) risks and benefits

A

Benefits: no abdominal surgery, shorter recovery, lower risk of infection, less blood loss

Risks: uterine rupture of the cesarean scar or uterus itself

31
Q

contraindications for TOLAC

A

staff, prior myomectomy, multiple sections, prior rupture, maternal/obstetrical issues, classic or T-shaped incision

32
Q

Highest risk for maternal morbidity and mortality is associated with

A

an unsuccessful TOLAC

33
Q

increasing success for TOLAC

A

Prior vaginal delivery, spontaneous labor

34
Q

decreased success for TOLAC

A

Increased gestational age > 40 wks., maternal obesity, preeclampsia, fetal macrosomia, prior shoulder dystocia, 2 prior cesareans without vag. Delivery

35
Q

neonatal outcomes from TOLAC

A

Increased uterine death due to uterine/scar rupture

36
Q

does epidural mask uterine rupture?

A

no

37
Q

stage I of labor is the ____________ stage

A

cervical

38
Q

regular and painful contractions

Complete dilation of cervix (10 CM)

A

stage I

39
Q

stage II is the ____________

A

pelvic stage

40
Q

stage from complete dilation to delivery of baby

A

stage II

41
Q

stage III is the ____________

A

placental stage

42
Q

From birth of baby to delivery of placenta

A

stage III

43
Q

first postpartum hour

A

stage IV

44
Q

3 components of labor and delivery

A

the powers, the passageway, the passenger

45
Q

Friedman Graph/Curve was traditionally used to define

A

normal length and pace of labor

46
Q

Freidman’s most important contribution was

A

separation of the latent phase from the active phase

47
Q

latent phase

A

preparatory phase

cervix becomes softer and effaces

48
Q

nulliparous latent phase

A

20 hours

49
Q

latent phase multiparous

A

14 hours

50
Q

active phase

A

cervical dilation and contractions

51
Q

nulliparous should dilate ____________ cm/hr

A

1.2 cm/hr

52
Q

multiparous should dilate ____________ cm/hr

A

1.5 cm/hr

53
Q

failure to progress is also called

A

primary dysfunctional labor

secondary arrest of dilation

54
Q

derived a labor curve using data from the National Collaborative Perinatal Project (CPP)

A

J. Zhang et al

55
Q

____________ women have a more gradual transition to active phase

A

nulliparous

56
Q

active phase in the multiparous begins around

A

6cm

57
Q

Most common factor associated with prolonged latent phase is

A

an “unripe” cervix at the start of labor

58
Q
A

OB Exam 1 (13 decks)

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