Normal Labor and delivery

Question 1

What is false labor?

Answer 1

• irregular contractions without cervical change

- to be “labor”, there needs to be cervical change

Question 2

What shape is the posterior fontanelle?

Answer 2

• a triangle

- we want that thing anterior

Question 3

What is the classic female type of pelvis?

Answer 3

-Gynecoid

Question 4

What is the classic male type of pelvis?

Answer 4

-android
-poor prognosis for delivery
-

Question 5

What pelvic shape will usually have an OP position at birth?

Answer 5

• anthropoid
• the ape pelvis: long narrow oval shape
• good delivery

Question 6

What is Platypelloid?

Answer 6

• flattened gynecoid
• short AP, wide transverse
• poor prognosis for delivery

Question 7

What is the diagonal conjugate?

Answer 7

• measurement from pubic symphysis to the sacral promontory

- that -2 is the obstetric conjugate; the narrowest fixed distance through which the fetal head must pass through

Question 8

What condition do we NOT do a cervical exam?

Answer 8

-placent previa!

Question 9

What are the leopold maneuvers

Answer 9

-just palpating parts of the baby

Question 10

Describe the different labor stages

Answer 10

• 1: onset of true labor to complete cervical dilation
• 2: complete cervical dilation to delivery of infant
• 3: deliver of infant to delivery of placenta
• 4: delivery of placenta to stabilization of patient

Question 11

When does thr first stage progress from latent to active?

Answer 11

-when the cervix gets to 4 cm

Question 12

4/50/-2…. what do these numbers mean?

Answer 12

• 4 cm dilated
• 50% effaced
• -2 cm station (that is pretty high up)

Question 13

What does the epidural do to the second stage of labor?

Answer 13

-make it a little longer

Question 14

What are the cardinal movements of labor?

Answer 14

• engagement (station 0)
• descent
• flexion: makes it so that the smaller suboccipitophregmatic diameter is the one that is presenting first
• internal rotation
• extension
• external rotation
• expulsion: ant should delivers before posterior

Question 15

What should we NOT do to the cord in the 3rd stage of delivery?

Answer 15

• pull on it before we know it’s ready to deliver

- could result in inversion

Question 16

What is the most common cause of postpartum hemorrhage?

Answer 16

-uterine atony

Question 17

What is the difference between induction of labor and augmentation of labor?

Answer 17

• induction: labor is induced by artifical means

- Augmentation: stimulation of labor which has already begun

Question 18

What do we use to predict the outcome of induction of labor?

Answer 18

• bishop score, if <6, unfavorable, do c section

- if >8, it will be fine

Question 19

What are some different cervical ripening agents?

Answer 19

• Cervidil: PGE2, vaginal insert, contraindicated if previous c section
• Cytotec: PGE1, cannot be readily removed, same contraindications
• mechanical dilators: foley bulb

Question 20

what is Pitocin?

Answer 20

• synthetic oxytocin which stimulates myometrial contractions
• piggy backed into main IV line so it can be stopped if we see fetal distress

Question 21

Why might opioids suck in pregnancy?

Answer 21

-they can cross the placental barrier and lead to neonatal respiratory depression

Question 22

What is the most comon induction agent used for general anesthesia?

Answer 22

-propofol

Question 23

Why are inhaled anesthetics bad sometimes?

Answer 23

-they can also readily cross placenta and cause neonatal respiratory depression