Vaginal delivery

Question 1

Disadvantage of median episiotomy

Answer 1

Higher rates of anal sphincter and rectal injury

Question 2

In cm, what is the vulvar opening during delivery of head?

Answer 2

5cm

Question 3

Used as fulcrum during head delivery

Answer 3

Symphysis

Question 4

Placement of hands on delivery of head

Answer 4

• One hand applies pressure on occiput

- Other hand with towel exert forward pressure to chin

Question 5

Movements on delivery of shoulders?

Answer 5

GENTLE downward traction to effect descent of anterior shoulder

GENTLE upward traction to effect descent of posterior shoulder

Question 6

Duration of 2nd stage of labor in nullipara and multipara

Answer 6

Nulli - 50 min

Multi - 20 min

Question 7

When is episiotomy done?

Answer 7

Once fetal head reaches perineum and scalp is seen with a diameter of 2-3cm

Question 8

What is Ritgen’s maneuver?

Answer 8

Support the perineum with one hand using a hand towel, apply upward pressure from coccygeal region to extend fetal head

Question 9

Position of shoulders during delivery

Answer 9

Anterior-posterior position

Question 10

Cutting of umbilical cord

• time?
• cc blood?
• mg iron?
• clamp cm from fetal abdomen?

Answer 10

3 min
30 cc blood
50 mg iron
4-5 cm

Question 11

Facilitate breastfeeding within __________ minutes

Answer 11

90 minutes

Question 12

Oxytocin dose?

Answer 12

10 mg IM

Question 13

Perineal reapproximation begins with?

Answer 13

Reuniting bulbocavernosus and transverse perineal muscles

Question 14

What is physiological or expectant management

Answer 14

Waiting for placental separations signs and allowing the placenta to deliver either spontaneously or aided by nipple stimulation or gravity

Question 15

Active management of 3rd stage of labor

Answer 15

UCD
Uterotonics
Controlled cord traction
Delayed cord clamping

Question 16

Uterotonic drugs

Answer 16

OCMMC
Oxytocin
Carbetocin
Methylergometrine
Misoprostol
Carboprost

Question 17

WHEN is 4th stage of labor

Answer 17

1-4 hrs after delivery of placenta

Question 18

Check vital signs every?

Answer 18

15 min, for 1 hr

Question 19

Episiotiomy for short perinuem

Answer 19

Mediolateral