Lecture 43 - Normal and Abnormal Labor

Question 1

Cervical effacement occurs when muscle fibers in the vicinity of the _____ ____ are pulled upward into the lower uterine segment. The cervix transitions from a 2cm tube like structure to a round, flat structure with very thin edges.

Answer 1

Internal os (the opening of the cervix into the corpus of the uterus –> basically where the cervix begins).

Question 2

_____cm is the average size of Complete dilation of the cervix.

Answer 2

10cm

Question 3

In the 1st stage of labor, the most important forces are those of _____ contraction.

In the 2nd stage of labor, the most important forces are those of increased __________ pressure and pushing.

Answer 3

Uterine

Intraabdominal pressure

Question 4

4 stages of Labor:

1. Onset of labor to ______
2. Full cervical dilation to delivery.
3. Delivery to passing of ______.
4. 2 hours postpartum/delivery of placenta.

Answer 4

1. Full cervical dilation

3. Passing of placenta

Question 5

What’s the difference between the Latent and Active phase of the 1st stage of labor?

Answer 5

Uterine contractions do NOT really induce dilation of the cervix in the Latent phase. Cervical dilation IS induced in Active phase. Keep in mind Latent phase is longer.

Question 6

The vast majority of women will have ___-____ contractions in 10mins during active labor, and this is considered adequate.

Answer 6

3-5

Question 7

If a placenta takes longer than ____mins to be spontaneously delivered, it is considered abnormal and will be manually removed.

Answer 7

30mins

Question 8

The latent phase of the 1st stage of labor is considered prolonged if it does not progress to the active phase within ____hrs for Nulliparous women or within _____hrs for multiparous women.

Answer 8

24hrs

14hrs

Question 9

Protraction disorders refers to prolongation of the Active phase of the 1st stage of labor and is defined as Cervical dilation that proceeds at < ____ cm/hr for Nulliparous women or < ____ cm/hr for Multiparous women.

Answer 9

< 1.2cm/hr –> nulliparous

< 1.5cm/hr –> multiparous women

Question 10

Arrest disorders of labor according to Friedman guidelines refers to EITHER:

the arrest of dilation of the cervix for > ____hr in BOTH nulliparous and multiparous women in the Active phase of the 1st stage of labor.

OR

the arrest of decent of the presenting part of the fetus for > ____hr in BOTH nulliparous and multiparous women in the 2nd stage of labor.

Answer 10

> 2hrs

OR

> 1hr

Question 11

The new definition of Arrest (so different from Friedman definition) in the 1st stage of labor has a requirement for cervical dilation of at least ____cm

AND

____+ hours of Adequate contractions or ____+ hours of inadequate contractions w/no cervical change.

Answer 11

6cm

4+ adequate

6+ inadequate

Question 12

Station is the term to describe the level of the fetal head relative to an imaginary line connecting the maternal ischial spines.

How do the values change with the fetal head above or below that line?

Answer 12

Station values are NEGATIVE for fetal head above the line and POSITIVE for fetal head below the line.