Parturition: Normal Labor & Delivery

Question 1

4 phases of Parturition (and duration)

Answer 1

Phase I - Quiescent phase (Conception - 2 weeks before labor)

Phase II - Activation phase
(2 weeks before labor - Onset of labor)

Phase III - Stimulation phase
(Onset of labor - Delivery of Placenta)

Phase IV - Involution
(Delivery of conceptus - Fertility restored)

Question 2

3 Stages of Labor

Answer 2

Stage I - Cervical Dilatation and Effacement

Stage II - Fetal Expulsion

Stage III - Placental Separation and Expulsion

Question 3

Stage I of Labor (Cervical Dilation and Effacement) Is further divided into 2 Phases:

Answer 3

Stage I (Cervical Dilation and Effacement)

> Phase I: Latent Phase (Perceived regular contractions - 3 cm dilation)

> Phase II: Active Phase (Cervix ≥ 3cm - 10cm)

Question 4

Active Phase of Stage I Labor further consists of 3 phases:

Answer 4

Active Phase (≥ 3cm - 10cm):
> Acceleration phase
> Phase of maximum slope
> Deceleration phase

Question 5

Stage I Labor (Latent phase):

Duration for nulliparas vs multiparas

Answer 5

Stage I Labor (Latent phase):

Nulliparas: ~ 20 hours
Multiparas: ~ 14 hours

Question 6

Stage I labor (Active phase):

Normal rate of cervical dilatation for nulliparas vs multiparas

Answer 6

Stage I labor (Active phase):

Nulliparas: 1.2cm/hour
Multiparas: 1.5cm/hour

Question 7

Which subphase of the Active phase of labor is a reflection of uterine contraction efficiency?

Answer 7

Phase of maximum slope

Question 8

Which subphase of the Active phase of labor predicts labor outcome

Answer 8

Acceleration phase

Question 9

Which subphase of the Active phase of labor reflects cephalopelvic relationships

Answer 9

Deceleration phase

Question 10

The 2nd Stage of Labor begins with what phase?

Answer 10

Descent phase

Question 11

7 Cardinal movements of Labor

Answer 11

1. Engagement
2. Descent
3. Flexion
4. Internal Rotation
5. Extension
6. External Rotation
7. Expulsion

Question 12

The Cardinal movements of labor begin in which phase?

Answer 12

Deceleration phase

Question 13

Shape of Friedman’s labor curve

Answer 13

Sigmoidal

Question 14

Asynclitism is a disorder of Engagement wherein the Sagittal suture of the fetus is not found midline between which landmarks of the bony pelvis?

Answer 14

Sacral promontory and symphysis pubis

Question 15

Disorder of Engagement wherein the sagittal suture of the fetus is deflected towards the sacral promontory?

Answer 15

Anterior asynclitism

Question 16

Disorder of Engagement wherein the sagittal suture of the fetus is deflected towards the symphysis pubis?

Answer 16

Posterior asyncitism

Question 17

3 Functional divisions of Labor

Answer 17

> Preparatory Division (Latent phase - acceleration phase)
Dilatational Division (Phase of maximum slope)
Pelvic Division (Deceleration - Descent)

Question 18

Landmark of the Pelvic inlet

Answer 18

Linea terminalis

Question 19

Landmark of the Midpelvis

Answer 19

Ischial spines

Question 20

Landmark of the pelvic outlet

Answer 20

Ischial tuberosities

Question 21

Cutoff value for Diagonal conjugate to ensure adequate passage

Answer 21

> 11.5cm

Question 22

Formula to compute for Obsetric conjugate

Answer 22

OC = DC - 1.5-2cm

Question 23

Johnson’s rule for Estimating Fetal weight

Answer 23

W = (FH - n) x 155

n = 12 if vertex is engaged
n = 11 if vertex is not engaged

Question 24

Palmar method for Estimating Fetal weight

Answer 24

W = 500g x no. of palms

Question 25

Maneuver during delivery wherein the head of the fetus is manually extended

Answer 25

Ritgen maneuver

Question 26

Signs of Placental separation

Answer 26

1. Gush of blood
2. Uterus becomes globular
3. Rise of uterus in the abdomen
4. Lengthening of the cord

Question 27

Placental separation mechanism wherein the maternal side appears first. Often bloody, followed by retained fragments

Answer 27

Dirty Duncan

Question 28

Placental separation mechanism wherein the fetal side appears first. Less bloody

Answer 28

Shiny Schultze

Question 29

At what measurement of cervical dilatation signals the Deceleration phase

Answer 29

8cm