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OB-Gyn > Parturition, Normal Labor and Delivery > Flashcards

Parturition, Normal Labor and Delivery Flashcards

0
Q

Phase of parturition - From implantation to few weeks before delivery

A

Prelude to parturition - phase 1 (Quiesence)

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1
Q

Principal hormone in the quiescence phase of parturition

A

Progesterone

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2
Q

Phase of parturition - Last 6-8 weeks of pregnancy (or 30-32 weeks AOG)

A

Preparation for labor/ Phase 2/ Activation

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3
Q

Phase of parturition - Process of Labor

A

Phase 3/ Stimulation

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4
Q

Hormone that serves as principal mediator in Phase 1 of parturition

A

Estrogen

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5
Q

At what phase of parturition are Braxton-Hicks felt

A

Phase 1/ Quiesence

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6
Q

At what phase of parturition is there formation of the lower uterine segment?

A

Phase 2/ Preparation for Labor/ Activation

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7
Q

At what phase of parturition does lightening happen?

A

Phase 2/ Activation/ Preparation for labor

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8
Q

At what phase of parturition is there formation is a physiologic uterine ring?

A

Phase 3/ Process of labor/ Stimulation

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9
Q

What initiates phase 3 of parturition/ stimulation?

A

Onset of labor/ regular contractions

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10
Q

What initiates phase 4 of parturition/ Involution?

A

Delivery of conceptus

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11
Q

When does phase 3 of parturition/ process of labor end?

A

Upon delivery of conceptus

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12
Q

Longitudinal axis of fetus to that of mother

A

Fetal lie (longitudinal or transverse)

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13
Q

MC fetal lie

A

Longitudinal

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14
Q

Most important force in fetal expulsion

A

Maternal intra-abdominal pressure

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15
Q

Portion of fetal body that is within the birth canal or in closest proximity to it

A

Fetal presentation

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16
Q

Most common fetal presentation

A

Cephalic (98%)

Breech (2.7%)

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17
Q

Fetal presentation if occipital fontanel is the presenting part?

A

Vertex

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18
Q

Fetal presentation if anterior fontanel is the presenting part?

A

Sinciput

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19
Q

Fetal presentation if the bregma is the presenting part?

A

Sinciput (same with anterior fontanel)

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20
Q

Fetal presentation with neck partially extended

A

Brow presentation

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21
Q

Sinciput presentation almost always converts to what presentation?

A

Vertex presentation by neck flexion

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22
Q

Brow presentation almost always concerts to what presentation?

A

Face presentation by neck extension

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23
Q

Fetal presentation with occipital fontanel as presenting part?

A

Occiput / Vertex presentation

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24
Q

Which fetal presentations are usually transient?

A

Sinciput and brow

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25
Q

3 Fetal presentations of breech?

A

Frank, complete, footling

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26
Q

Characteristic posture of fetus

A

Fetal attitude

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27
Q

Relationship of the chosen portion of the fetal presenting part to the right or left side of the maternal birth canal

A

Fetal position

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28
Q

MC fetal position

A

Left occiput anterior

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29
Q

Possible fetal positions if with vertex presentation

A

Left occiput anterior
Left occiput transverse
Left occiput posterior

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30
Q

Possible fetal positions if with face presentation

A

Left mentum anterior
Left mentum transverse
Left mentum posterior

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31
Q

Possible fetal positions if with breech presentation

A

Left sacrum anterior
Left sacrum transverse
Left sacrum posterior

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32
Q

Presenting part if vertex presentation?

A

Occiput

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33
Q

Presenting part if face presentation?

A

Mentum

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34
Q

Presenting part if breech presentation?

35
Q

Degree of descent of the presenting part throughout the birth canal

36
Q

At what level is the fetal station assessed?

A

Level of the ischial spine

37
Q

Lateral deflection of the head to a more anterior or posterior position in the pelvis

A

Asynclitism

38
Q

Sagittal suture approaches sacral promontory; anterior parietal bone presents

A

Anterior synclitism/ Naegele’s obliquely

39
Q

Sagittal suture lies close to symphysis pubis; posterior parietal bone will present

A

Posterior asynclitism/ Litzman obliquity

40
Q

Litzman obliquity

A

Aka posterior asynclitism

Sagittal suture lies close to symphysis pubis; posterior parietal bone will present

41
Q

Naegele’s obliquity

A

Aka anterior asynclitism

Sagittal suture approaches sacral promontory; anterior parietal bone presents

42
Q

Maneuver to determine fetal pole

43
Q

Leopold I

A

Determines fetal pole

44
Q

Leopold II

A

Determines where the fetal back is

45
Q

Leopold III

A

What fetal part lies over the pelvic inlet

46
Q

Leopold IV

A

On which side is the cephalic prominence

47
Q

At which Leopold maneuver does the examiner move to the mother’s feet?

A

Leopold IV

48
Q

Pawlick’s grip

A

Aka Leopold III

Determines engagement of presenting part

49
Q

Fundal grip

A

Aka Leopold I

Determines fetal part lying in the fundus

50
Q

Leopold maneuver which determines the degree of flexion of fetal head/ neck?

A

Leopold IV

51
Q

Leopold maneuver to determine habitus?

A

Leopold IV

52
Q

Cephalic or podalic?

A

Presentation

From Leopold I

53
Q

To determine engagement of presenting part

A

Leopold III/ Pawlick’s grip

54
Q

Period of forceful uterine contractions that cause cervical dilatation, fetal descent and delivery of the conceptus

55
Q

3 tests used to confirm rupture of membranes

A

Pool test
Nitrazine test
Fern test

56
Q

Amniotic fluid - acidic or alkaline?

57
Q

Normal vaginal pH?

58
Q

Positive nitrazine test?

A

If paper turns blue = positive = pH 7.5 (amniotic fluid is alkaline)

Positive = rupture of membranes

59
Q

If negative nitrazine test?

A

Paper turns yellow = pH 5

60
Q

Results of fern test

A

Amniotic fluid causes crystallization under microscope when it dries up

61
Q

Bishop score that indicates high probability of spontaneous vaginal delivery

62
Q

Ring of Bandl

A

Aka pathologic retraction ring

Extreme thinning of LUS in obstructed labor

63
Q

First prerequisite for birth

64
Q

BPD passes through the pelvic inlet

A

Engagement

65
Q

Cardinal movement that allows the narrowest fetal head diameter to present in the birth canal

66
Q

What happens during internal rotation?

A

Rotation of fetal head from transverse to AP

67
Q

Another name for restitution

A

External rotation

68
Q

Anesthesia that can be used for both 1st and 2nd stages of labor

69
Q

Functional division of first stage of labor that’s unaffected by sedation or conduction analgesia

A

Dilatational division

70
Q

BPD descent in relation to the ischial spine

71
Q

Landmark in assessing fetal station

A

Ischial spine

72
Q

Ritgen maneuver

A

Hand used to exert forward pressure on the chin of the fetus through the perineum just in front of the coccyx and the other hand exerts pressure posteriorly against the occiput

73
Q

Encircling of the largest diameter of the fetal head by the vulvar ring

74
Q

Calkin sign

A

Uterus becomes global and firm - 3rd stage of labor

75
Q

Placental separation where glistening amnion first presents at vulva

76
Q

Placental separation that occurs first at the periphery

A

Duncan

“Duncan’s dirty mother at the periphery “

77
Q

3rd degree laceration

A

Involves anal sphincter

78
Q

Fourth degree laceration

A

Until rectal mucosa

79
Q

First degree laceration

A

Fourchette, perineal skin, vaginal mucous membrane

80
Q

Second degree laceration

A

Fascia and perineal muscles

81
Q

4th stage of labor begins?

A

Hour immediately after deliver

Monitor for at least 1 hour (q15)

82
Q

Bishop score favorable for labor induction

83
Q

Oxytocin dose

A

10-20 units into 1000 ml of LRS

84
Q

Early amniotomy at what cervical dilatation?

85
Q

Late amniotomy at what cervical dilatation?

86
Q

Misoprostol - what type of drug?

A

PGE1 analog

Used for cervical ripening and induction

OB-Gyn (12 decks)

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