1M - Parturition

Question 1

Clinical labor is what phase of parturition?

Answer 1

Phase 3

Question 2

This is the quiescence stage of parturition?

Answer 2

Phase 1

Question 3

This is the phase of parturition where contractile unresponsiveness and cervical softening are manifested?

Answer 3

Phase 1

Question 4

This phase of parturition involves the uterine preparation for labor, cervical ripening and formation of the lower uterine segment?

Answer 4

Phase 2

Question 5

What are the stages of labor?

Answer 5

Contraction, cervical dilation and fetal and placental expulsion

Question 6

This phase of parturition involves the involution of the uterus, cervical repair and breastfeeding?

Answer 6

Phase 4

Question 7

This phase of parturition can be called the phase of parturient recovery?

Answer 7

Phase 4

Question 8

What do you call the low intensity myometrial contractions that are felt during the quiescent stage and this normally do not cause cervical dilation?

Answer 8

Braxton Hicks contractions or false labor

Question 9

To maintain quiescence, prostaglandins are are markedly increased? T or F?

Answer 9

False

They are suppressed

Question 10

What genetic defects can cause cervical insufficiency during pregnancy?

Answer 10

Ehler Danlos Syndrome and Marfan syndrome

Question 11

This phase of parturition may also be called the phase of uterine awakening or activation?

Answer 11

Phase 2

Question 12

When does phase 2 of parturition start?

Answer 12

Last few weeks of pregnancy

Question 13

How long does the Phase 1 of parturition last?

Answer 13

Start of pregnancy until near the end of pregnancy

Question 14

Phase 2 of parturition happens because of the withdrawal of what hormone?

Answer 14

Progesterone

Question 15

This phase of of parturition involves the formation of the lower uterine segment and the descent of the fetus to or through the pelvic inlet?

Answer 15

Phase 2

Question 16

Oxytocin receptors level rise during phase 2 of parturition, what are the primary regulators of oxytocin receptor expression?

Answer 16

Estrogen and progesterone

Question 17

This hormone maintains uterine quiescence through inhibition of myometrial oxytocin response?

Answer 17

Progesterone

Question 18

This substance is largely responsible for the structural disposition of the cervix?

Answer 18

Collagen

Question 19

Production of these substances during cervical ripening is thought to increase viscoelasticity, hydration and matrix disorganization?

Answer 19

Glycosaminoglycans and proteoglycans

Question 20

Inflammatory substances are increased during stage 2 of parturition. T or F?

Answer 20

True

Question 21

Therapies to prevent cervical ripening are present? T or F?

Answer 21

False

Question 22

What are the fetal contributions to parturition?

Answer 22

Fetal stretch, Fetal endocrine cascades, Surface Protein A

Question 23

This fetal substance from the placenta and decidua is required for lung maturation of the fetus?

Answer 23

Surface Protein A

Question 24

Before 37 weeks of gestation, and before lightening, what organs does the uterus compress into?

Answer 24

Lungs and diaphragm

Question 25

After 37 weeks, or after lightening, what organs are compressed by the fetus?

Answer 25

Bladder and cervix

Question 26

What are the characteristics of true labor?

Answer 26

Contraction, Cervix, Fetus Contractions are regular, increased in intensity and duration when walking, felt along the lower back to the abdomen Bloody show Dilation and effacement of the cervix fetus is engaged

Question 27

What are the characteristics of false labor?

Answer 27

Contraction, Cervix and Fetus Irregular contractions - braxton hicks contractions Cervix is unchanged fetus is ballotable

Question 28

Stage 1 of labor is the dilatation of the cervix from?

Answer 28

0 - 10 cm

Question 29

This stage of labor starts from complete dilatation to the effacement and delivery of the fetus?

Answer 29

Stage 2

Question 30

This stage of labor starts from the delivery of the baby to the delivery of the placenta?

Answer 30

Stage 3

Question 31

This stage of labor happens at the first hour after delivery?

Answer 31

Stage 4

Question 32

This process begins with the onset of regular uterine contractions and ends with delivery of the newborn and expulsion of the placenta

Answer 32

Labor

Question 33

What are important fetal factors to be considered by the mechanism of labor?

Answer 33

Fetal lie, fetal presentation, fetal attitude or posture, fetal position

Question 34

This relation of the fetal axis to that of the mother?

Answer 34

Fetal Lie

Question 35

What is the fetal lie in more than 99% of labors at term?

Answer 35

Longitudinal lie

Question 36

Transverse lie predisposes the mother and fetus to what conditions?

Answer 36

Hydramnios. Placenta previa, uterine anomalies

Question 37

If the fetal and maternal axis crosses at a 45 degree angle, what is the fetal lie?

Answer 37

Oblique lie

Question 38

This is defined by the presenting part of the fetal body that is in closest proximity to the birth canal?

Answer 38

Fetal presentation Either cephalic or breech for longitudinal shoulder for transverse

Question 39

What is the fetal presentation if the presenting part is the occipital fontanel?

Answer 39

vertex or occiput presentation

Question 40

If the neck is only partly flexed what is the presenting part and the fetal presentation?

Answer 40

anterior fontanel; sinciput presentation

Question 41

If the fetal neck is partially extended, what is the fetal presentation?

Answer 41

Brow Presentation

Question 42

If the fetus has its neck sharply extended, what is the fetal presentation?

Answer 42

face presentation

Question 43

Sinciput and brow presentation can convert to vertex or face presentation as labor progresses? T or F?

Answer 43

True

Question 44

Failure of the fetal presentation to convert to vertex or face presentation can result to what condition?

Answer 44

Dystocia

Question 45

Describe Frank Breech presentation?

Answer 45

Hips are flexed and thighs are extended

Question 46

Describe complete breech presentation?

Answer 46

Both the hips and thighs are flexed

Question 47

Describe footling breech?

Answer 47

At least one foot presents below the pelvis

Question 48

This is defined as a characteristic posture that the fetus assumes in the later months of pregnancy?

Answer 48

Fetal attitude or posture

Question 49

What is the common fetal attitude?

Answer 49

Convex

Question 50

If the fetal attitude is well flexed, what is it called?

Answer 50

Suboccipitobregmantic - 9.5 cm

Question 51

If the fetal attitude is less well flexed or deflexed, what is it called?

Answer 51

occipitofrontal - 11.5cm

Question 52

If the fetal presentation is brow presentation, what is the fetal attitude?

Answer 52

Occipitomental (extended fetal attitude) - 13 cm

Question 53

If the fetal attitude is hyperextended, what is the fetal presentation?

Answer 53

Face presentation Fetal attitude is called submentobregmatic - 9.5 cm

Question 54

This refers to the relationship of an arbitrary chosen portion of the presenting part to the right or left of the birth canal?

Answer 54

fetal Position

Question 55

What Leopold's maneuver identifies which fetal pole occupies the fundus? (fetal presentation)

Answer 55

LM 1 (if breech or cephalic)

Question 56

Which Leopold's Maneuver determines the fetal lie?

Answer 56

LM2 (Longitudinal, transverse or oblique)

Question 57

Which Leopold's maneuver checks whether the fetus is already engaged or not?

Answer 57

LM 3

Question 58

What Leopold's Maneuver checks for the fetal position?

Answer 58

LM 4 (LOT, ROA, etc)

Question 59

Enumerate the cardinal movements of labor in order?

Answer 59

Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

Question 60

This is the mechanism in whihc the biparietal diameter passes through the pelvic inlet?

Answer 60

Engagement

Question 61

This is the first requisite of birth?

Answer 61

Descent

Question 62

In nulliparas, descent happpens together with engagement? True or false?

Answer 62

False, it is in multiparas In nulliparas, engagement may happen before labor and further descent may not follow until onset of second stage of labor

Question 63

This cardinal movement is the change from suboccipitobregmatiic to the longer occipitofrontal diameter?

Answer 63

Flexion

Question 64

Movement of the head in such a manner that the occiput gradually moves toward the symphysis pubis anteriorly or less commonly posteriorly towards the sacrum

Answer 64

Internal Rotation

Question 65

This cardinal movement brings the base of the occiput into direct contact with the inferior margin of he symphysis pubis?

Answer 65

Extension

Question 66

This cardinal movement of labor takes place when the head reaches the vulva.

Answer 66

Extension

Question 67

This cardinal movement is also called restitution which returns the head into the oblique position and completion towards transverse position of the shoulders.

Answer 67

External rotation

Question 68

This cardinal movement of labor brings the bisacromial diameter of teh fetus in relation to the AP diameter of the pelvic outlet

Answer 68

External Rotation

Question 69

This cardinal movement of labor happens immediately after external rotation?

Answer 69

Explulsion

Question 70

This is defined by uterine contractions that bring about effacement and dilatation of the cervix?

Answer 70

labor

Question 71

This division of the first stage of labor is characterized by little dilatation and cervical connective tissue changes?

Answer 71

Preparatory division

Question 72

This division of the first stage of labor is also called the latent phase?

Answer 72

Preparatory division

Question 73

What measurement of cervical dilatation indicates the start of active labor?

Answer 73

6 cm

Question 74

This division of the 1st stage of labor is affected by anesthesia?

Answer 74

Preparatory division

Question 75

This division of 1st stage of labor is characterized by rapid dilatation and is unaffected by sedation or anesthesia?

Answer 75

Dilatational division

Question 76

What is prolonged latent phase?

Answer 76

Multiparas - 14 hrs Nulliparas - 20 hrs

Question 77

This division of 1st stage of labor is called the deceleration phase of cervical dilatation?

Answer 77

Pelvic Division

Question 78

This division of 1st stage of labor is where cardinal movement of labor begins?

Answer 78

Pelvic division

Question 79

This stage of labor starts with complete cervical dilatation and ends with fetal delivery?

Answer 79

2nd stage

Question 80

What are indications of labor?

Answer 80

Uterine contractions 5 minutes apart for 1 hour and cervical dilatation of more than 4 cm

Question 81

What bishop score is favorable for labor induction or augmentation?

Answer 81

Bishop score of 8 Review bishop scoring

Question 82

When can we say that the cervix is fully dilated?

Answer 82

10 cm

Question 83

Intrapartum fetal heart rate monitoring for normal OB patient interval?

Answer 83

Every 30 minutes for 1st stage and every 15 minutes for 2nd stage

Question 84

Intrapartum fetal heart rate monitoring for high risk pregnnacy?

Answer 84

Every 15 minutes for 1st stage and every 5 minutes for 2nd stage

Question 85

Interval for cervical examination during the first stage of labor?

Answer 85

Ever 2-3 hrs

Question 86

Food can be freely taken during the active stage of labor and delivery? T or F?

Answer 86

False

Question 87

What position is most likely comfortable for the woman in labor?

Answer 87

Lateral recumbent

Question 88

What position is typically avoided to avert aortocaval compression?

Answer 88

Supine

Question 89

This degree of laceration involves only the vaginal epithelium or the perineal skin?

Answer 89

1st degree

Question 90

Degree of laceration that involves the perineal muscles (bulbospongiosus and superficial transverse perineal msuscles) but spares the anal sphincter complex

Answer 90

2nd degree

Question 91

What is involved in 3A 3rd degree laceration?

Answer 91

< 50% of the external anal sphincter 3B is >50% of the external anal sphincter

Question 92

What is involved in the 4th degree laceration?

Answer 92

Perineal body, entire anal sphincter complex and anorectal mucosa