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Parturition > Physiology of labor > Flashcards

Physiology of labor Flashcards

1
Q

How many phases of parturition are there?

A

Four

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2
Q

The phases of parturition correspond to the major physiological transitions of which organs?

A

Uterus and cervix

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3
Q

Which parts of the uterus is primarily associated with parturition?

A

Myometrium and cervix

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4
Q

Myometrial quiescence comprises how much of the pregnancy?

A

95% of the pregnancy

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5
Q

Which contractions are felt near the end of pregnancy, but do not normally cause cervical dilatation?

A

Braxton-Hicks contractions or false labor

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6
Q

In nonpregnant women, the consistency of the cervix is similar to: nasal cartilage or lips of the oral cavity?

A

Nasal cartilage

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7
Q

What is the first stage of the remodeling of the nonpregnant cervix to adapt to pregnancy?

A

Softening

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8
Q

What is the main structural protein of the cervix?

A

Collagen

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9
Q

What is altered in cervical collagen during softening?

A

The number or types of cross-links between collagen triple helices

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10
Q

The following changes occur in the active segment of the uterus EXCEPT
A. successive lengthening of the muscle fibers
B. upper part of uterine becomes smaller with each successive conduction
C. progressive thickening
D. constant myometrial tension

A

A

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11
Q

The following are true regarding cervical changes EXCEPT:
A. cervical ripening is an inflammatory procedure
B. cervical softening is preceded by a decrease in collagen solubility
C. before cervical ripening, collagen fibrils are uniform in size, well-packed, and organized
D. during cervical ripening, collagen fibrils are dispersed, resulting in loss of tissue integrity and increased tissue compliance

A

B

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12
Q 
25 y/o G2P1 presents with fetus at 39 weeks AOG, with regular uterine contractions, intact membranes, 1 cm cervical dilatation, 50% cervical effacement. What is the functional division of labor? What phase of parturition?
A.	Phase 0
B.	Phase 1
C.	Phase 2
D.	Phase 3
A

D

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13
Q 
25 y/o G2P1 presents with fetus at 39 weeks AOG, with regular uterine contracctions, intact membranes, 1 cm cervical dilatation, 50% cervical effacement. What is the functional division of labor?
A.	Dilatational
B.	Preparatory
C.	Pelvic
D.	Acceleration
A

B

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14
Q

True statement about the Phase 2 except
A. Uterine changes during the last 10 weeks of pregnancy
B. Most myometrial changes occur in preparation for labor contractions
C. Formation of the lower uterine segment
D. Myometrial oxytocin receptors markedly increased

A

A

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15
Q

True statements about involution except
A. The uterus has descended into the cavity of true pelvis within 2 weeks
B. The uterus returns to its non-pregnant size within 8 weeks
C. The fundus is palpable below the umbilicus immediately after placental expulsion
D. Complete placental … up to 6 weeks

A

B

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16
Q

Complaint felt by the mother when she said the baby “dropped”.

a. Engagement
b. Descent
c. Lightening
d. Fetal lie

A

C

17
Q

Complaint felt by the mother when she said the baby “dropped”.Condition is due to:

a. Formation of lower uterine segment
b. Decrease in amniotic fluid
c. False labor
d. Change in gravity

A

A

18
Q

Complaint felt by the mother when she said the baby “dropped”. Uterine phase where this occurs:

a. Phase 1
b. Phase 2
c. Phase 3
d. Phase 4

A

B

19
Q

Following factors predominant during phase 3 parturition except

a. Progesterone
b. Prostaglandin
c. Oxytocin
d. Relaxin

A

A

20
Q

True statements during active labor EXCEPT:

a. Upper segment is firm during contractions
b. Lower segment is softer and more passive
c. Lower segment contracts, retracts, expels
d. Softened cervix dilates and forms an expanded thinned out tube

A

C

21
Q

The uterine phase of parturition which is characterized by uterine contraction and retraction to prevent puerperal haemorrhage:

a. Phase 1
b. Phase 2
c. Phase 3
d. Phase 4

A

D

22
Q

Modifications of the cervix during phase 1 of parturition except
A. Collagen breakdown and rearrangement of fibers
B. Increase in dermatan sulfate
C. Increase in hyaluronic acid
D. Increase in amount of cytokines

A

B

23
Q

True statements about the increase in width of the symphisis pubis:
A. Occurs more in primigravidas than multiparas
B. Returns to normal soon after delivery
C. Permanent change in multiparas
D. Permanent change in primigravidas

A

B

24
Q 
Which phase of parturition is characterized by myometrial contraction and retraction to prevent excessive bleeding after delivery of infant
A. Phaso 0
B. Phase 1
C. Phase 2
D. Phase 3
A

D

25
Q

Increased myometrial contractility due to mechanical stretching of cervix

a. Ferguson’s reflex
b. Lightening reflex
c. Bandl’s ring
d. Braxton-hicks

A

A

26
Q

TRUE of oxytocin during parturition EXCEPT:
A. increased oxytocin receptors
B. stimulates decidua to increase progesterone release
C. increased maternal levels at the second stage of labor
D. increased maternal levels at early post partum period

A

B

27
Q

possible causes of pain durin labor EXCEPT:

a) hypoxia of the contracted myometrium
b) nerve ganglia compression in the cervix
c) stretching of the LUS during dilation
d) stretch of the peritoneum overlying the fundus

A

C

28
Q

True statements about cervical effacement except:
A. Muscles at internal os are pulled upward
B. Shortening of cervical canal
C. Causes expulsion of mucus plug
D. Obliteration takes place from below then upward

A

D

29
Q

True statement about lightening except

a. occurs with the development of the lower uterine segment
b. observed in phase 0 of parturition
c. fetal head descends through the pelvic inlet
d. mother complains that it seems the baby dropped

A

B

30
Q 
Brief, unpredictable, and very low intensity myometrial contractions occuring near the end of pregnancy:
A. Ferguson reflex
B. Lightening reflex
C. Bandl's ring
D. Braxton-Hicks contractions
A

D

31
Q 
During normal labor as a result of lower segment thinning and upper segment thickening, a boundary btw the two is marked by a ridge on the inner uterine surface is referred to as
A. Ferguson's reflex
B. Physiological retraction ring 
C.Bandl's ring
D. Braxton hicks
A

B

32
Q

. When the cervix is fully dilated, what is the most important force in the expulsion of the fetus?

a. maternal intra-abdominal pressure
b. Ferguson’s reflex
c. pressure from amniotic fluid
d. fundal pressure exerted by attendant

A

B

33
Q 
Mrs. Ferrer is a 25 yo G2P1 (1001) at 39 weeks AOG, consulted at the ER for passage of blood-tinged mucts from the vagina associated with the onset of regular uterine contraction. On IE, cervix is 1cm dilated, 50% effaced midline in position with intact bag of water. Stage of labor: 
A. Stage 0. 
B. Stage 1 
C. Stage 2. 
D. Stage 3.
A

B

34
Q 
. Occurs in the placental delivery except:
A. Uterus globular and firmer
B. Sudden gush of amniotic fluid
C. Uterus rises
D. Umbilical cord protrudes of vagina
A

B

35
Q 
What endogenous hormone is responsible for uterine contraction postpartum?
A. Progesterone
B. Prolactin
C. Oxytocin
D. Estrogen
A

C

36
Q

Changes in the urinary tract during the postpartum period EXCEPT:
A. Puerperal bladder has decreased capacity and sensitivity to intravesical pressure
B. Edema and hyperemia of bladder wall
C. Overdistention, incomplete emptying and excessive residual urine are common
D. Postpartum patients are more prone to develop urinary tract infection

A

A

Parturition (6 decks)

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