Normal Labor

Question 1

What is the G TPAL classification?

Answer 1

Gravidity
Parity
-term
-preterm
-abortions
-living children

Question 2

When is gestation measured from?

Answer 2

The first day of the last menstrual period

Question 3

What is the definition of Preterm labor? Post Term?

Answer 3

Prior to 36 weeks

Continuing beyond 42 weeks

Question 4

What are the phases of labor

Answer 4

Phase 0: quiet through inhibitors
Phase 1:  Cervical Softening
Phase 2: Oxytocin receptors inc. uterine irritability. Cervical Ripening. Progest Withdrawl. CRH
Phase 3: Labor. 
Phase 4: Peurperium. Myometrium rigid

Question 5

What are the inhibitors of labor?

Answer 5

Progesterone
Prostacyclin
Relaxin

Question 6

What are the Powers, Passenger, and Passage?

Answer 6

Powers: Force gen by uterus:
Passenger: Fetus

Question 7

What factors are measured in contractions?

Answer 7

Frequency, Duration, Intensity

Question 8

What factors are measured in the Passenger?

Answer 8

Size
Lie: relat. of fetal spine to maternal spine
Presentation: fetal part that directly overlies the pelvic inlet
Position: Rel between fetus and maternal pelvis (3 initials)
MatFetMat

Question 9

What is compound presentation?

Answer 9

More than one fetal part presenting

Question 10

What is Malpresentation?

Answer 10

Any presentation that isn’t cephalic with occiput leading

Question 11

What Are the factors considered in Passage?

Answer 11

Obstetric Conjugate (smallest part of the pelvic inlet)
and Shape of Inlet

Question 12

What are the different shapes of the female bony pelvis?

Answer 12

Gynecoid- Classic Oval (most common)
Anthropoid- Exaggerated oval
Android- Male- Heart shaped
Platypelloid- Broad, flat

Question 13

What are the Stages of Labor?

Answer 13

Latent - change in rate of dilation
Active- Most cerv dilation
Descent(2nd stage)- Pushing

Question 14

What are the complications to regional anesthesia?

Answer 14

Hypotension
Post Dural headache
Fever
Bradycardia

Question 15

What are the absolute contraindications to Regional anesthetic?

Answer 15

Refracory hyotension
Coagulaopathy
Thrombocytopenia
LMWHep
Untreated Bacteremia
Skin infection over site of needle
ICP caused by mass

Question 16

What is the regional block used just for the perineum?

Answer 16

Pudendal nerve block

Question 17

What are the cardinal movements of labor?

Answer 17

Engagement,
Descent,
Flexion,
Int Rot,
Extension,
Ext Rot,
Expulsion

Question 18

What are the parts of the Initial assessment in labor?

Answer 18

Review Prenatal record
Focused History
PE
Labs: CBC, blood type/Rh, Ab screen, 
HIV, Hep B, syphilis

Question 19

What is included in Intrapartum management?

Answer 19

Suportive Care
First Stage: FHR q30 min D&AC
Second Stage: FHR q15 min
Linited oral intake
Electronic fetal monitoring

Question 20

When should cervical dilation be checked?

Answer 20

On admission
1st stage: 1-4 hrs
Prior to analgesia
When feel urge to push 
Fetal heart abnormalities (umbilical cord)

Question 21

What is the Passive and Active management during delivery of the placenta?

Answer 21

Passive: Lengthening of UC
Gush of blood 
Change in shape of fundus
Active: Oxytocin
Controlled Cord Traction