Human Birth Exam 2 Lecture 2 (2/24)

Front 1

What is the purpose of Cuna in Levi Strauss' paper?

Back 1

Facilitate delivery in certain cases of childbirth.

Front 2

When does the intervention of the shaman occur in Levi Strauss' paper?

Back 2

The intervention of shaman is rare and occurs in cases of failure after request of a midwife

Front 3

What is Muu according to Levi Strauss' paper?

Back 3

Muu is the spirit that is thought to be in charge of hte reproductive capacities of the women. It is in charge of the uterus, the development of the fetus

Front 4

When does difficult childbirth occur according to Levi Strauss' paper?

Back 4

Difficult childbirth occurs when Muu has exceeded her functions and has captured the soul or the Purba, soul of the pregnant woman;

Front 5

What does the shaman do to alleviate the difficult childbirth in Levi Strauss' article?

Back 5

The shaman sings a song. By doing this, he is undertaking a quest through the spirit world to recapture the Pubra, liberate her uterus, so that normal delivery takes place

Front 6

Each bodily organ of the pregnant woman has its own ________ according to Levi Strauss' paper.

Back 6

Purba, soul

Front 7

When does the shaman intervene in the case of difficult childbirth according to Levi Strauss' paper?

Back 7

Shaman intervenes when Indian midwife cannot get the baby out with use of all techniques. Shaman manages to accomplish psychological manipulation of sick uterus in difficult labor to deliver baby.

Front 8

Why is levi strauss' paper ridiculous?

Back 8

He is suggesting that a woman in truly difficult labor could be cured by the shaman singing the song without any physical manipulation of her pelvis

Front 9

What does Professor Wall believe Levi Strauss' paper represents?

Back 9

He believes it represents an obstetrical prayer for deliverance rather than an obstetrical tool with clinical track record for success

Front 10

What is Dystocia?

Back 10

Difficult Labor

Front 11

What are the three factors involved in expulsions during dystocia?

Back 11

1. Powers - mechanical forces involved in expulsions
2. Passage - for instance, birth canal
3. Passenger - Fetus size and shape and how it is loaded into birth canal

Front 12

What are the four types of abnormalities that occur with dystocia?

Back 12

1. Expulsive Forces - related to contraction of uterus, sometimes contractions are not strong enough or coordinated enough to produce effective effacement of cervix
2. Fetus - abnormalities in presentation of fetus into birth canal, position of fetus, and development of fetus
3. Boney Abnormalities - abnormalities in bony architecture of pelvis can be extreme
4. Soft Tissue Abnormalities - fat is an example of soft tissue that obstructs birth, obese women have more difficult labor because too much fat for fetus to get through

Front 13

What is most common presentation of fetus in birth canal?

Back 13

Occiput Anterior - head firts

Front 14

What is the most common reason for C Section in the US?

Back 14

Dystocia

Front 15

What is second most common reason for C Section?

Back 15

Fetal Intolerance to labor where people observing labor feel baby is not tolerating labor and feel it is at risk for developing distress

Front 16

What are the two components of the first stage of labor and describe them?

Back 16

1. Latent - early stages of cervical dilation stops at 4 cm
2. Active Phase - 4cm - 10 cm, women who are having their first delivery can last up to 12 hours in this phase.

Front 17

What are the two phases you are having if your uterus is not contracting properly?

Back 17

Hypotonic - weak contractions that are not strong enough to row the boat forward nad get baby out

Hypertonic - elevated unterine contraction and uterus never relaxed appropriately, uncoordinated uterine contractions

Front 18

What percent of babies are in breach fetal position?

Back 18

3%

Front 19

What is Frank Breach position?

Back 19

Buttocks comes down first and extremities are flexed at knees

Front 20

What is complete breach?

Back 20

One or both knees are flexed rather than both being extended

Front 21

What is Incomplete breach?

Back 21

One of knees maybe extended so what you have is one of lower extremeties as the presenting part, either knee or foot

Front 22

What are the two problems with breach?

Back 22

Problem 1 - normally head comes down first since it is biggest part, now if biggest part comes out last it may get trapped in cervix if uterus not fully dilated

Problem 2 - umbilical cord can hang down the cervix or pull on head in breach

Front 23

What is umbilical cord prolapse? What does the physician do during this situation?

Back 23

Extreme obstetrical emergency and leaves to extreme loss of human dignity because you want to preserve babies life and you have to get pressure and head off umbilical cord, so women have to get on knees with head as low as possible and somebody sticks hand up vagina and pushes baby's head off cord and then do C Section

Front 24

Breach positions have higher incidence of __________.

Back 24

Prematurity

Front 25

Breach positions is also associated with higher _____ of mother because of higher rate of operative delivery.

Back 25

Morbidity

Front 26

When are breach presentations very common? Why is it better to occur during this time?

Back 26

Early pregnancies; In early pregnancies, the baby continues to move so it is okay but as pregnancy progresses, babies come to rest in head down position and remain there into third trimester

Front 27

What do physicians try to do in late pregnancy breach positions?

Back 27

External Cephalic Version - try to turn head from outside and induce labor immediately

Front 28

What is Face Presentation?

Back 28

This is when the face is presenting rather than back of head. The leading point is the chin.

Front 29

How often does face presentation occur?

Back 29

1 in 600 delivieries

Front 30

When does face presentation usually occur?

Back 30

When bony diameters of pelvis are not normal so head flexes incorrectly as it starts to go through mechanism of labor

Front 31

What are problems associated with face presentation?

Back 31

possibility of breaking heck if chin is presenting

Front 32

T/F Chin-posterior face presentation is one that cannot be delivered through pelvis because of physics.

Back 32

True

Front 33

What is Brow Presentation?

Back 33

Forehead is presenting. This is rare presentation that usually converts to face or occiput

Front 34

What is the worst presentation?

Back 34

Transverse Lie - the long axis of fetus is perpendicular to the long axis of mother -> uterus ruptures and baby asphyxiates

Front 35

What are compound presentations?

Back 35

Varieties that involved extremities presenting simultaneously with a presenting part

Front 36

What is most common compound presentation?

Back 36

Occiput with hand coming down along with it

Front 37

What does physician do for Occiput Posterior Presentation?

Back 37

These rotate spontaneously and deliver okay. Some require forceps for rotation and some just cannot make it out and they end up with C Section.

Front 38

What is Fetal Macrosomia?

Back 38

BIG BABY > 4500 grams , increase in body size related to head size making it difficult to deliver shoulders

Front 39

What predisposes someone to have fetal macrosomia?

Back 39

Diabetes, Big Parents, Birth Order (babies bigger in successive pregnancies), Fat Women, Long Pregnancy

Front 40

What was used to get the biggest baby out during childbirth?

Back 40

Blunt Hook

Front 41

How big was the biggest baby?

Back 41

24 lb with 4lb placenta and 35 inches long

Front 42

What is shoulder Dystocia?

Back 42

Baby's body is big size in relation to head so there is trouble with delivering shoulder after delivering head. Shoulder is trapped behind pubic symphysis

Front 43

What is the Turtle Sign?

Back 43

It is a sign of shoulder dystocia because head pops out and snaps back in because shoulder is not descending. This is an emergency and you must get baby out in short period of time or you will get asphyxiation. Do not pull on head!

Front 44

How should a physician deal with Turtle Sign?

Back 44

Get a fat labor and delivery nurse and have her put pressure on pubic symphysis to see if you can pop shoulder out and rotate patients thighs up so you will change axis of outlet. Or you can split perineum or split pubic symphysis in half or push baby back in and do C Section.

Front 45

What is Fetal Hydrocephalis?

Back 45

too much Water on the brain inside of head. It is caused by defect in development of brain so normal circulation of cerebral spinal fluid is impaired so fetal head grows to enormous size which is impossible to get out of vagina, There is almost no brain left because pressure in skull has destroyed brain

Front 46

How do you deliver a fetal hydrocephalis baby?

Back 46

Puncture fetal skull, decompress head, and deliver baby vaginally

Front 47

What is hydrops?

Back 47

Fetal swelling of body, particularly abdomen

Front 48

What is Locked Twins?

Back 48

Two separate individuals who are not conjoined but happen to get entangled. They are both coming out simultaneously so you can't disarticulate them.