Quiz 7: Monitoring the condition of the foetus during the first stage of labour

Question 1

Compression of the fetal head during labour:

Usually does not harm the fetus

Usually damages the fetal brain

Usually causes blindness in the newborn infant

Usually kills the fetus

Answer 1

Usually does not harm the fetus

Question 2

What is the commonest cause of a reduced supply of oxygen to the fetus during labour?

Uterine contractions

Partial placental separation

Placental insufficiency

Infection of the membranes

Answer 2

Uterine contractions

Question 3

How does the fetus usually respond to a lack of oxygen during labour?

There is an increase in fetal movements.

There is a decrease in the fetal heart rate.

There is an increase in the fetal heart rate.

There is a decrease in fetal movements.

Answer 3

There is a decrease in the fetal heart rate.

Question 4

How should the fetal heart rate be monitored in labour?

A cardiotocograph (CTG machine) should preferably be used in all labours.

A doptone is the preferred method in primary-care clinics and hospitals.

A fetal stethoscope is the best method for most labours.

The fetal heart rate does not need to be monitored in all low-risk pregnancies.

Answer 4

A doptone is the preferred method in primary-care clinics and hospitals.

Question 5

The fetal heart rate pattern should be monitored:

During a contraction

Before a contraction

After a contraction

Before, during, and after a contraction

Answer 5

Before, during, and after a contraction

Question 6

How often should the fetal heart rate be monitored during the first stage of labour in low-risk pregnancies where there is no meconium staining of the liquor?

Every 3 hours during the latent phase

Every 2 hours during the latent phase

Every 2 hours during the active phase

Every 15 minutes during the active phase

Answer 6

Every 2 hours during the latent phase

Question 7

What is the normal baseline fetal heart rate in labour?

100–120 beats per minute
120–140 beats per minute
140–160 beats per minute
110–160 beats per minute

Answer 7

110–160 beats per minute

Question 8

Early decelerations:

Start at the beginning of a contraction and return to the baseline at the end of a contraction

Start at the beginning of a contraction and end 30 seconds or more after the contraction

Do not have any relation to contractions

Occur during the period of uterine relaxation

Answer 8

Start at the beginning of a contraction and return to the baseline at the end of a contraction

Question 9

Early decelerations are usually caused by:

Intracranial haemorrhage

Compression of the fetal head

A short umbilical cord

A decreased supply of oxygen to the fetus

Answer 9

Compression of the fetal head

Question 10

What are late decelerations?

Decelerations that occur after 38 weeks gestation

Decelerations that are only present at the end of the first stage of labour

Decelerations that start 30 seconds or more after the beginning of the contraction

Decelerations that return to the baseline 30 seconds or more after the end of the contraction

Answer 10

Decelerations that return to the baseline 30 seconds or more after the end of the contraction

Question 11

Late decelerations:

Always indicate fetal distress

Only suggest that fetal distress may be present

May be normal

Cannot be diagnosed with a fetal stethoscope

Answer 11

Always indicate fetal distress

Question 12

A baseline tachycardia:

Indicates that the fetus is in good condition

Is common when the mother is given pethidine

May be caused by infection of the placenta and membranes

Indicates that the fetus is dying from lack of oxygen

Answer 12

May be caused by infection of the placenta and membranes

Question 13

A baseline bradycardia:

Is a safe pattern

Is a pattern which indicates an increased risk of fetal distress

Indicates severe fetal distress

Is usually caused by infection of the placenta and membranes

Answer 13

Indicates severe fetal distress

Question 14

Which fetal heart rate pattern warns that there is an increased risk of fetal distress?

Early decelerations

Late decelerations

Baseline bradycardia

Late decelerations plus a baseline bradycardia

Answer 14

Early decelerations

Question 15

When can you be confident that the fetal condition is good?

When the baseline fetal heart rate is normal and there are no decelerations

When the baseline fetal heart rate is normal and there are only early decelerations

When fetal tachycardia is present and there are no decelerations

All of the above

Answer 15

When the baseline fetal heart rate is normal and there are no decelerations

Question 16

Meconium staining of the liquor:

Is uncommon

Occurs in 10–20% of patients

Occurs in 30–40% of patients

Occurs in most patients

Answer 16

Occurs in 10–20% of patients

Question 17

Meconium staining of the liquor is commonest in:

Patients in post-term labour

Patients in term labour

Patients in preterm labour

Patients whose fetuses move a lot during pregnancy

Answer 17

Patients in post-term labour

Question 18

Which form of meconium in the liquor is most likely to indicate the presence of fetal distress?

Fresh meconium indicates definite fetal distress and is an indication for an emergency Caesarean section.

Old meconium indicates that there was a problem but that there is no need to be concerned

Yellow meconium is of no clinical importance

The management is the same as it does not matter what the consistency or colour of the meconium is

Answer 18

The management is the same as it does not matter what the consistency or colour of the meconium is

Question 19

Why does a fetus pass meconium during labour?

Because there is fetal hypoxia

Because it makes the second stage of labour shorter

Because the mother has been given liquid paraffin

Because it is mature and ready for delivery

Answer 19

Because there is fetal hypoxia

Question 20

What is the correct management when the liquor is meconium stained?

Monitor the fetal heart rate carefully.

Deliver the fetus immediately by Caesarean section.

Give the patient an oxytocin infusion to shorten labour.

Transfer the patient urgently to a level 3 hospital.

Answer 20

Monitor the fetal heart rate carefully.