Normal Labour & The Partograph

Question 1

What is Labour?

Answer 1

Labour is the onset of painful regular contractions with progressive cervical effacement and dilatation that terminates with delivery of fetus and placenta

Question 2

Labor management involves what interplay?

Answer 2

Ethical, medical and social

Question 3

How is labor initiated?

Answer 3

Mechanism of labour initiation is unknown

Question 4

Factors that may be responsible for initiating labour can be either?

Answer 4

Fetal or Maternal

Question 5

Maternal factors that may initiate labour?

Answer 5

1. Oxytocin release/receptors
2. Prostaglandins release/receptors
3. Retraction of uterine muscles

Question 6

What fetal factor can initiate labour?

Answer 6

Oxytocin release from posterior pituitary gland

Question 7

The outer bony parts of the pelvic inlet is the?

Answer 7

Pelvic brim

Question 8

The pelvic inlet separates?

Answer 8

The greater(false) pelvis from the lesser(true) pelvis

Question 9

The pelvic inlet separates?

Answer 9

The greater(false) pelvis from the lesser(true) pelvis

Question 10

The boundaries of the pelvic brim are?

Answer 10

Anterior: Pubic symphysis
Posterior: Sacral Promontory
Lateral: Ala of the ilium, upper margins of the pubic bone, iliopectineal line

Question 11

Boundaries of pelvic mid cavity?

Answer 11

Anterior: Middle of the pubic symphysis
Posterior: Junction between 2nd and 3rd bones of sacrum
Lateral: Obturator fascia, inner parts of ischial bones and spine

Question 12

Boundaries of Pelvic Outlet

Answer 12

Anterior: Inferior part of pubic symphysis
Posterior: Last piece of Sacrum
Lateral: Ischial tuberosity, inferior pubic ramus, sacrotuberous ligament

Question 13

Antero-posterior diameter of the pelvic brim of the female pelvis is?

Answer 13

11cm

Question 14

Transverse diameter of the pelvic brim is?

Answer 14

13.5cm

Question 15

Angle of inclination of pelvic brim to the horizontal in an erect position is?

Answer 15

60°

Question 16

The angle of inclination to the horizontal in Afro Caribbean women can be up to?

Answer 16

90°

Question 17

The fetal skull has three major parts. What are they?

Answer 17

Face, Base and Vault

Question 18

The bones of the cranial vault in fetus are?

Answer 18

Majorly the parietal bone, then parts of the frontal, temporal, and occipital bones.

Question 19

How many sutures are present on the fetal skull?

Answer 19

Coronal, Sagittal, Lambdoid and Frontal

Question 20

What are the fontanelles on a fetal skull?

Answer 20

Anterior and Posterior fontanelles

Question 21

What are the diameters of the fetal skull?

Answer 21

Sub occipito bregmatic: 9.5cm (Flexed vertex presentation)
Sub occipito frontal: 10cm (Partially flexed vertex presentation)
Occipito-frontal: 11.5cm (Deflexed presentation)
Mento-vertical : 13cm (Brow)
Sub mento bregmatic : 9.5cm (face)

Question 22

There are how many stages of labour?

Answer 22

Three stages

Question 23

The first stage of labour can be up to what cm of cervical dilatation?

Answer 23

10cm

Question 24

The 1st stage of labour is divided into?

Answer 24

Latent phase and Active phase

Question 25

Characteristics of latent phase (1st stage of labour)

Answer 25

Cervical dilatation is < 4cm Woman has at least 1 contraction every 10 minutes

Question 26

In the active phase of 1st stage of labor, cervical dilatation is?

Answer 26

At least 4cm

Question 27

What happens in the second stage of labour?

Answer 27

Full cervical dilatation (10cm) to delivery of the fetus

Question 28

The third stage of labor comprises of?

Answer 28

The delivery of the fetus and the placenta

Question 29

Changes in attitude and position that a fetus undergoes as it passes through the birth canal is?

Answer 29

Mechanism of labor

Question 30

The Mechanism Of Labor is?

Answer 30

1. Engagement 2. Descent 3. Flexion 4. Internal Rotation 5. Extension 6. Restitution 7. External Rotation

Question 31

Duration of the latent phase of labor?

Answer 31

8 hours

Question 32

Latent phase of labour that last ≥ 8 hours is?

Answer 32

Prolonged latent phase

Question 33

Latent phase of labor lasting more than 24 hours is regarded as?

Answer 33

False labour

Question 34

Duration of Active laborr

Answer 34

12 hours

Question 35

List the eight steps for the management of normal labor

Answer 35

1. Provide care and emotional support 2. Observe pregnancy and be ready for timely intervention if it becomes abnormal. 3. Monitor fetal wellbeing 4. Administer adequate and appropriate pain relief consistent with the woman's wishes. 5. Adequate hydration to prevent ketosis. 6. Review obstetric history 7. Examination (General Physical, Abd, and Vaginal examinations) 8. Fetal assessment in labor

Question 36

What is a partograph?

Answer 36

A partograph is a graphic record of labor that allows the rate of cervical dilatation against the expected norm to be instantly visualized

Question 37

A partograph was thought to reduce four things. What are they?

Answer 37

1. Prolonged labour 2. Incidence of Caesarean section 3. Augmentation with oxytocin 4. Need for analgesia in labour

Question 38

In the BioData part of the partograph, what are the recordings?

Answer 38

1. Name 2. Gravidity 3. Hospital Number 4. Date & time of admission 5. Time of membrane rupture

Question 39

Other things displayed on the partograph besides cervical dilatation rate and BioData are?

Answer 39

1. Frequency and strength of contractions 2. Descent of fetal head. 3. Quantity and color of amniotic fluid 4. Moulding 5. Temperature 6. Proteins 7. Fetal heart rate 8. Blood pressure 9. Pulse rate

Question 40

1. Fetal heart rate should be recorded every ______ 2. Pulse rate should be recorded every ____ 3. On the partograph, pulse rate is marked with a _____

Answer 40

1. 30 minutes 2. 30 minutes 3. Dot

Question 41

Blood pressure should be recorded every ______ and is marked by ___

Answer 41

1. Four hours 2. C/O

Question 42

Temperature on the partograph should be recorded every ______

Answer 42

2 hours

Question 43

When should proteins be recorded?

Answer 43

After every passage of urine

Question 44

Amniotic fluid inspection and cervical dilatation should be done during?

Answer 44

Every vaginal examination

Question 45

The meaning of each of these letters in inspection of amniotic fluid is? M B I R C

Answer 45

M - Meconium stained fluid B - Blood-stained fluid I - Membrane intact R - Membrane ruptured C - membrane ruptured, clear fluid

Question 46

Cervical dilatation is marked as ___ on the partograph

Answer 46

X