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OB GYN > Parturition > Flashcards

Parturition Flashcards

0
Q

Concurrently, the cervix begins an early stage of remodeling termed _____, yet maintains structural integrity

A

Softening

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1
Q

During the first _______ weeks of normal gestation, the myometrium is in a preparatory yet unresponsive state

A

36-38 weeks

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2
Q

Following this prolonged uterine quiescence, there is a _____ phase during which myometrial unresponsiveness is suspended, and the cervix undergoes ripening, effacement, and loss of structural integrity

A

Transitional

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3
Q

bringing forth of young, requires multiple transformations in both uterine and cervical function

A

Parturition

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4
Q

The phases of parturition includes:

A

Prelude
Preparation
Process
Recovery

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5
Q

Contractile unresponsiveness

A

Phase 1

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6
Q

Cervical softening

A

Phase 1

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7
Q

Uterine preparedness for labor

A

Phase 2

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8
Q

Cervical ripening

A

Phase 2

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9
Q

Uterine contraction

A

Phase 3

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10
Q

Cervical dilation

A

Phase 3

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11
Q

Fetal and placenta expulsion

A

Phase 3

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12
Q

Uterine involution

A

Phase 4

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13
Q

Cervical repair

A

Phase 4

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14
Q

Breast feeding

A

Phase 4

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15
Q

This phase begin even before implantation

A

Phase 1

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16
Q

This is characterized by smooth muscle tranquility with maintenance of cervical structural intergrity

A

Phase 1

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17
Q

The myometrial unresponsiveness of phase 1 continues until ____

A

Near end of pregnancy

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18
Q

Uterine myometrial smooth muscle is rendered unresponsive to natural stimuli

A

Phase 1

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19
Q

Uterine quiescence is characterized by their ____, ___, ____

A

Unpredictability
Low intensity
Brief duration

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20
Q

Any discomfort in the uterine quiescent phase is confined in the ____ and ___

A

Lower abdomen

Groin

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21
Q

Near the end of pregnancy, contractions of this type become more common especially in multiparous women

A

Braxton hicks contractions or False labor

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22
Q

The cervix has multiple functions during pregnancy which includes:

A
  • maintenance of barrier function: protection form reproductive tract infection
  • maintenance of cervical competence: despite increasing gravitational forces imposed by the expanding uterus
  • orchestrating extracellular matrix changes: allow progressive increase in tissue compliance
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23
Q

In non-pregnant women, the cervix is ___ and ____, and its consistency is similar to the ____

By the end of pregnancy the cervix is easily ____

A

Closed and Firm
Nasal Cartilage

Distensible

24
Q

Characterized by an increase in tissue compliance, yet the tissue remains firm and unyielding

A

Softening

25
Q

Cervical shortening is between ____ and ____ weeks has been associated with an increased risk of _____

A

16-24 weeks

Preterm delivery

26
Q

Cervical softening results from:

A

Increased vascularity
Stromal hypertrophy
Glandular hypertrophy and hyperplasia
Compositional or structural changes of the extracellular matrix

27
Q

Physiological softening is preceded by an increased in ____

A

Collagen solubility

28
Q

Uterine awakening and activation

A

Phase 2

29
Q

Phase 2 of parturition represents a progression of changes in the uterus during the ____ of pregnancy

A

6-8 weeks

30
Q

What are the contraction associated proteins?

A

Oxytocin receptors
Prostaglandin receptors
Connexin 43

31
Q

Agents that stimulates contractions

A

Uterotonins

32
Q

Myometrial oxytocin receptors markedly increase along with increased numbers and surface areas of gap junction proteins such as connexin 43

A

Phase 2

33
Q

This phase leads to increase uterine irritabiltyand responsiveness of uterotonins

A

Phase2

34
Q

The critical change in phase 2

A

Formations of the lower uterine segment from the isthmus

35
Q

With this development, the fetal head often descend to or even through the pelvic inlet

A

Lightening

36
Q

In phase 2 cervical modifications during the second phase principally involves the change in the connective tissue

A

Cervical ripening

37
Q

The cervix is made up of only ____ % smooth muscles with the remaining tissue comprises mainly of connective tissues which includes:

A

10-15%

C - collagen type 1,3,4
G - GAG
P - proteoglycan
E - elastin

38
Q

This material is the major component of the cervix and is largely responsible for its structural disposition

A

Collagen

39
Q

Each collagen molecule is composed of ______ which wind around each other to form ____

A

Three alpha chains

Procollagen

40
Q

High molecular weight polysaccharides that contain amino acids and can form complexes with proteins to form ____

A

GAG

Proteoglycans

41
Q

Hyaluronans’ functions are dependent on the ____ and the ____ products which is carried out by a family of enzymes termed _____

A

Size
Breakdown of the large molecular weight HA to small molecular weight

Hyaluronidases

42
Q

These glycoproteins are found in abundance in the cervix and changes in this composition also accompanies cervical ripening

A

Proteoglycans

43
Q

At least two small leucine-rich proteoglycans are found in the cervix ____ and ____

A

Decorin

Biglycans

44
Q

In these Phases there is increased cervical expression of chemokines and collagenase / proteases activity

A

Phase 3 and 4

45
Q

This is considered an inflammatory process

A

Cervical ripening

46
Q

Promotes cervical ripening for labor induction

A

Prostaglandin E2 and F2

47
Q

Modify collagen and alter relative GAG concentration

A

PGE2 and PGF2

48
Q

This phase is synonymous to active labor

A

Phase 3

49
Q

This phase is customarily divided into three stages of labor

A

Phase 3

50
Q

Begins when widely spaced uterine contractions of sufficient frequency, intensity, and duration are attained to bring about cervical thinning

A

Stage of cervical effacement and dilation

51
Q

Term for cervical thinning

A

Effacement

52
Q

This labor stage end when the cervix is fully dilated to allow passage of the fetal head

A

Cervical effacement and dilation

53
Q

Begins when cervical dilatation completes and end with delivery

A

Stage of fetal expulsion

54
Q

Begins immediately after delivery of the fetus and ends with the delivery of the placenta

A

Placental separation and expulsion

55
Q

Predictive in the outcome of a particular labor

A

Acceleration phase

56
Q

Good measure of over all efficiency of the uterus

A

Phase of maximum slope

57
Q

Reflective of feto-pelvic relationship

A

Deceleration phase

OB GYN (11 decks)

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