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Obstetrics > Vaginal Delivery > Flashcards

Vaginal Delivery Flashcards

1
Q

What type of delivery has the lowest risk of maternal comorbidity?

A

Vaginal delivery

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2
Q

What is the most common and satisfactory position during delivery?

A

Dorsal lithotomy position

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3
Q

What is the most common position of baie sin cephalic position?

A

Occiput anterior

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4
Q

What is the the encirclement of the largest head diameter by the vulvar ring?

A

Crowning

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5
Q

How to prevent spontaneous vaginal lacerations?

A

Antepartum/Intrapartum Perineal Massage
-> 34-35 weeks AOG

Insert 1 or 2 fingers 3cm into the vagina then apply

Downward pressure for 2 mins & Laterally on each side for 2mins

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6
Q

What are the 2 maneuvers done to control acceslerative forces in order to slow deliveryof the head?

A

Modified ritgen maneuver = DONE if the power is inadequate

Hands-on method

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7
Q

What is the amt of degrees of lateral deviaiton of the neck?

A

25-45 degrees

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8
Q

Where do you clamp the umbilical cord?

A

2-3cm from its isnertion into the fetal abdomen
6-8cm from the fetal abdomen

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9
Q

When do you clamp the umbilical cord?

A

30-60 secs or until cord pulsation ceases

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10
Q

What are the benefits of proper timing of cord clamping?

A

Increase total iron stores
Expand blood volume
Decrease incidence of aneima

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11
Q

What are the benefits of delayed cord clamping in preterm neonates?

A
  • Decreases rate of blood transfusion adn death before hospital discharge
  • Prevents intraventricula rhemorrhage
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12
Q

What are the predisposing risk factors of persistent occiput posterior position?

A

Epidural anesthesia
Nulliparity
Greater fetal weight
Prior OP delivery
Anthropoid pelvis
Narrow subpubic angle

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13
Q

What is the Turtle sign?

A

One indicator may be retraction of the baby’s head against the mother’s perineum

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14
Q

What are the maternal consequences of dystocia?

A

Serious perineal tears
Postpartum hemoarrhage

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15
Q

What are the neonatal consequences of dystocia?

A

Neuromusculoskeletal injury
Asphyxia

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16
Q

At what AOG do u wait against induction for suspected macrosomia alone?

A

39 wees

17
Q

What are the 2 maneuvers done to disipact anterior shoulder that is stuck at th e symphysis pubis?

A
  1. McRoebrts maneuver
  2. Mazzanti maneuver (abdomina approach)
  3. Rubin maneuver
18
Q

What is the diff betw Rubin manuever and WOod’s screw maneuver?

A

Rubin = freeing impacted ANTERIOR shoulder by exerting pressure on the POSTERIOR aspect of the anterior shoulder

Wood’s screw = freeing POSTERIOR shoulder by exerting pressure on the ANTERIOR aspect of the posterior shoulder

19
Q

What are the goals in third stage of labor?

A

Deliveryof intact placenta
Avoidance ofuterine inversion
Prevent postpartum hemorrhage

20
Q

What is the expectant management during thirs stage of labor?

A

Nipple stimulation or by gravity = gush of blood suddenly, globular and firmer fundus, lengthening of the umbilical cord, elevation of the uterus into the abdomen

4-12 minutes

21
Q

What are the active amnagemetn of 3rd stage of labor?

A

Early/delayed cord clamping
Controlled cord traction during placental delivery
Immediate prophylactic administration of a uterotonic agent

22
Q

What aer the diff Uterotonics?

A

Oxytocin
Methylergonovine
Misoprostol
Carboprost

23
Q

What are the immediate postpartum care?

A

1st hr after placental delivery
Placental and cord inspection
Vigilant monitoring for uterine atony and hemorrhage
Perineum must be inspected for alcerations and hematoma

24
Q

What aer the factors favoring cesarean delivery of the breech fetus?

A

Lack of operator experience
Patient request for cesarean delivery
Prior perinatal death or neonatal birth trauma

25
Q

What are the diff partial breech extraction?

A

Pinard’s maneuver
Lovset manuever
Mauriceau maneuver
Piper forceps
Modified prague maneuver

Obstetrics (4 decks)

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