OBN: Dystocia Flashcards
Cut-off values for protracted active phase in nullipara and multipara
Nullipara - <1.2cm/hr
Multipara - < 1.5cm/hr
Cut-off values for protracted descent in nullipara and multipara
Nullipara - <1cm/hr
Multipara - <2cm/hr
Cut-off values for prolonged deceleration phase in nullipara and multipara
Nullipara - >3hrs
Multipara - >1hr
Cut-off values for prolonged latent phase in nullipara and multipara
Nullipara - >20hrs
Multipara - >14hrs
____ is when there is no descent in deceleration or 2nd stage of labor
Failure of descent
Cut-off values for arrest of descent in both nullipara and multipara
> 1hour
____ is the cut-off time to be considered a precipitous labor
Fetal expulsion <3hours
____ is the lateral deflection of the saggital suture posteriorly toward the sacral promontory or anteriorly toward the symphysis pubis.
Asynctilism
The distal conjugate measures 10cm. This is suggestive of ____ pelvic inlet
Contracted.
DC more than 11.5cm means adequate pelvic inlet
The bispinous diameter is 8.5cm. This is suggestive of ____ midpelvis
Adequate.
BSD of <8cm suggests contracted midpelvis
The bituberous diameter measures 8cm. This suggests a ____ pelvic outlet
Adequate.
BTD of <= 8cm suggests contracted pelvic outlet
____ maneuver wherein the physician reaches the most anterior fetal shoulder, which is then pushed toward the anterior surface of the fetal chest
Rubin’s maneuver
___ maneuver. Using the heel of clasped hand, suprapubic pressure is applied by another member of the team to the posterior aspect of the anterior shoulder to ABDUCT THE SHOULDER.
Mazzanti maneuver
What is the criteria for adequate labor
- > 6cm, ruptured BOW AND
- > 4 hours of adequate contractions OR
- > 6 hours if inadequate contraction and no cervical change
Prolongation disorder happens in what stage of labor?
First Stage
What is the intervention for prolonged latent phase?
Oxytocin drip
Patient is in active phase of the cervical dilatation is ___
> 3cm-5cm
What is the management for protracted active phase?
Amniotomy with early oxytocin to shorten labor
Patient is on prolonged deceleration phase if the cervical dilatation is at ____
8-10 cm
Nulli >3 hours
Multi >1 hour
[Diagnose and intervention]
G1P0, 9cm for 4 hours station -2
Prolonged deceleration phase
If no CPD: Oxytocin
If with CPD: CS
[Diagnose and intervention]
G3P2, 9cmm for 2 hours station -2
prolonged deceleration phase
If no CPD: Oxytocin
If with CPD: CS
[Diagnose and intervention]
G1P0, 10 cm, station 3 for 2 hours
Arrest of descent
If no CPD: Oxytocin
If with CPD: CS
When will you consider CS in abnormal labor?
- 4 hours of uterine contractions of >200 MVU without cervical change
- 6 hours of oxytocin augmentation for inadequate contractions
[Contributing factor to complications]
Prolonged or desultory labor
- Chorioamnionitis
2. Postpartum pelvic infection
[Contributing factor to complications]
Prolonged augmented labor
- Postpartum hemorrhage from atony
[Contributing factor to complications]
High parity, prior CS
Uterine rupture
[Contributing factor to complications]
Prolonged second stage
Fistula formation from necrosis
[Contributing factor to complications]
second stage and maternal expulsive efforts
- urinary incontinence
2. Pelvic organ prolapse
[Contributing factor to complications]
Inappropriate leg positioning in stirrups in prolonged stage 2
compression of the common fibular (peroneal) nerve
[Contributing factor to complications]
Prolonged labor
- Fetal sepsis
- Caput succcedaneum
- Molding
[Shoulder dystocia]
Head to body delivery time > ___ seconds
60 seconds
