Normal labor

Question 1

what does G TPAL stand for?

Answer 1

gravidity

parity (term, preterm, abortions, living)

Question 2

definition: labor

Answer 2

increase in myometrial activity resulting in effacement and dilation of the uterine cervix

Question 3

mean duration of human singleton pregnancy

Answer 3

280 days (40 wk) from first day of LMP

Question 4

what is a term pregnancy?

Answer 4

period from 36 completed weeks (37.0) to 42.0 weeks

Question 5

what is a preterm pregnancy?

Answer 5

onset of labor prior to 36 completed weeks

Question 6

what is a postterm pregnancy?

Answer 6

continuing beyond 42 weeks

Question 7

is labor diagnosed clinically or medically?

Answer 7

clinically

Question 8

what are the criteria for labor diagnosis?

Answer 8

• regular painful contractions
• progressive cervical effacement and dilatation
• bloody show

Question 9

phase 0 of labor

Answer 9

functional quiescence through inhibitors: progesterone, prostacyclin, relaxin

Question 10

phase 1 of labor

Answer 10

cervical softening: slow progressive structural changes of ECM (collagen alterations)

Question 11

phase 2 of labor

Answer 11

activation - myometrial changes, cervical ripening

Question 12

phase 3 of labor

Answer 12

actual labor - three stages:

• oxytocin influence
• PGs, relaxin
• CRH

Question 13

oxytocin really has its effect during which phase of labor?

Answer 13

phase 3

Question 14

phase 4 of labor

Answer 14

• puerperium (postpartum interval)
• myometrium becomes rigid and in state of constant contraction - oxytocin influence
• uterine involution and cervical repair

Question 15

what are the three mechanics of labor?

Answer 15

powers
passenger
passage

Question 16

the ‘powers’ mechanics of labor are generated by what?

Answer 16

uterus

Question 17

how is uterine activity described?

Answer 17

• frequency
• intensity
• duration

Question 18

what is the classic definition of adequate uterine activity (how many contractions / minute)?

Answer 18

3-5 contractions in 10 minutes

Question 19

definition: lie

Answer 19

spatial relationship of fetal spine to maternal spine

Question 20

definition: presentation

Answer 20

fetal part that directly overlies the pelvic inlet

Question 21

what does a compound presentation mean?

Answer 21

more than one fetal part directly overlies the pelvic inlet

Question 22

what does malpresentation mean?

Answer 22

any presentation that is not cephalic with occiput leading

Question 23

what is the best type of lie?

Answer 23

vertically oriented (longitudinal)

Question 24

definition: fetal position

how is it described?

Answer 24

• relationship between a fetal denominator and the maternal pelvic
• described by 3 initials:
• 1st initial: fetal denominator
• 2nd and 3rd initial: maternal pelic quadrants toward which the fetal denominator points

(e.g. LOA, LOP)

Question 25

what spot on the fetus marks the orientation?

Answer 25

posterior fontanelle (occiput)

Question 26

definition: station

Answer 26

relationship of presenting part to maternal ischial spines

Question 27

what does a "0" station mean? negative value?

Answer 27

head is at the ischial spines negative value - above the spines

Question 28

what is the name for the smallest part of the pelvic inlet?

Answer 28

true (obstetric) conjugate

Question 29

what is the true (obstetric) conjugate?

Answer 29

smallest part of the pelvic inlet

Question 30

what type of pelvic shapes is most conducive to labor?

Answer 30

gynecoid

Question 31

what is the limiting factor for passage in the midcavity?

Answer 31

interspinous diameter

Question 32

definition: stage 1 of labor

Answer 32

interval between onset of labor and full cervical dilation

Question 33

what are the three subdivisions of stage 1 of labor?

Answer 33

- latent - active - descent

Question 34

definition: latent phase of stage 1 labor

Answer 34

- between onset of labor and a point at which a change in slope of rate of cervical dilation is noted - slow cervical change

Question 35

definition: active phase of stage 1 labor

Answer 35

- greater rate of dilation | - most dilation

Question 36

the most dilation, and greatest rate of dilation, occurs at what point of labor? at what cervical dilation value does it start?

Answer 36

active phase of stage 1 labor 4 cm

Question 37

uterine contraction corresponds to what spinal levels?

Answer 37

T10 - L1

Question 38

what is the most common complication of regional anesthesia?

Answer 38

hypotension

Question 39

what are the durations of labor for nulliparous women? (total, 1st, 2nd, 3rd stages)

Answer 39

total: 10-26 hr first: 10-24 hr second: 30-120 min third: 5-30 min

Question 40

how do nulliparous labors compare with multiparous labors in terms of duration of stages?

Answer 40

30 minute 3rd stage

Question 41

definition: stage 2 of labor

Answer 41

interval between full cervical dilation and delivery of infant

Question 42

definition: stage 3 of labor how long does this usually take?

Answer 42

- deliver of placenta | - less than 10 m (up to 30 m)

Question 43

what are the changes in position of the fetal head during passage through the birth canal?

Answer 43

- engagement - descent - flexion - internal rotation - extension - external rotation - expulsion