Normal Labor And Delivery

Question 0

MC fetal lie

Answer 0

Longitudinal

Question 1

Longitudinal axis of fetus to that of mother

Answer 1

Fetal lie

Question 2

Portion of fetal body closest or within birth canal

Answer 2

Fetal presentation

Question 3

MC fetal presentation

Answer 3

Cephalic

Question 4

Fetal attitude

Answer 4

Fetus bent on itself convex
Flexed head thighs knees
Chin in contact with chest
Arms crossed over thorax

Question 5

Relationship of fetal presenting part to R/L maternal birth canal

Answer 5

Occiput Anterior L

Question 6

Leopold’s maneuver

Answer 6

Fundal Grip
Fetal back
Pawlik’s grip engagement
Attitude or habitus, degree of head flexion

Question 7

Asynclitism
Naegele’s obliquity
Litzman

Answer 7

Ant parietal bone, sagittal suture to sacral promontory

Post parietal bone, symphisis pubis

Question 8

Regular with shortening intervals and inc intensity
Hypogastric to lumbar
Cervical effacement and dilatation
No effect of sedation

Answer 8

True labor

Question 9

Clinical signs of labor

Answer 9

Bloody show mucus plug extrusion

Spontaneous ROM

Question 10

Amniotic Fluid tests to confirm ROM

Answer 10

Pool
Nitrazine blue
Fern crystallization

Question 11

Parameters of cervical exam

Answer 11

Effacement
Dilation
Consistency
Position

Question 12

Assesses favorability for successful delivery given cervical status and labor induction

Answer 12

Bishop score

>8 cm

Question 13

Bishop score

Answer 13

Effacement
Dilation
Consistency
Position
Station

Question 14

Most impt force in expulsion of the fetus

Answer 14

Maternal intra-abdominal pressure

Question 15

Cardinal movements

Cephalic

Answer 15

Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Expulsion

Question 16

Cardinal movements

Breech

Answer 16

Descent
Engagement
Internal rotation
Lateral flexion
Delivery
Restitution

Question 17

Cardinal movements

Face

Answer 17

Descent
Internal rotation
Flexion
Accessory ext rotation and expulsion

Question 18

First stage of labor
Latent phase
Active phase

Answer 18

1-4 cm N20h M14h
4-10 cm N1.2cm/h M1.5 cm/h
- acceleration: outcome of labor
- max slope 8cm: efficiency
- deceleration: fetopelvic relationship

Question 19

Second stage of labor

Answer 19

Completion of descent and cardinal movements

N50mins M20mins

Question 20

Third stage of labor

Answer 20

Delivery of placenta

5 mins

Question 21

Management of first stage

Answer 21

Anesthesia
Stage 1 natural, IM/IV meperidine or morphine, paracervical anesthetic in vaginal fornices, epidural
Stage 2 epidural pudendal nerve block

Question 22

One hand exerts forward pressure on fetal chin through perineum. Other hand pushes against occiput

Answer 22

Ritgen maneuver

Question 23

Median episiotomy

Answer 23

More likely to extend to rectum

Question 24

Mediolateral episiotomy

Answer 24

More difficult repair and healing More pain and blood loss Less cosmetic Less extension to rectum

Question 25

Signs of placental separation

Answer 25

Calkin globular and firm uterus Gush of blood Uterus rises in abdomen Lengthening of UC

Question 26

Placental extrusion Schultze Duncan

Answer 26

Central glistening amnion | Peripheral maternal surface

Question 27

``` Lacerations of birth canal First Second Third Fourth ```

Answer 27

Fourchette, perineal skin, vaginal mucous membrane Fascia and perineal muscles Anal sphincter Rectal mucosa