Obgyn Ch 6 Intrapartum Care

Front 1

Which of the following is NOT required for a diagnosis of true labor?

Back 1

blood show

(true labor - rhythmic contractions, cervical dilatation, cervical effacement)

Front 2

At term, bloody show is associated with

Back 2

extrusion of endocervical gland mucus

Front 3

Low back pain is commonly associated with

Back 3

both active and false labor

Front 4

Uterine contractions of increasing intensity are commonly associated with

Back 4

active labor

Front 5

Spontaneous onset of uterine activity is commonly associated with

Back 5

both active and false labor

Front 6

Progressive cervical dilation is commonly associated with

Back 6

active labor

Front 7

Lower abdomen and groin pain are commonly associated with

Back 7

false labor

Front 8

Waxing and waning intensity of uterine contractions is commonly associated with

Back 8

false labor

Front 9

Progressive cervical effacement is commonly associated with

Back 9

active labor

Front 10

Which of the following is characteristic of "Braxton Hicks" contractions?

Back 10

all of the above (rhythmic contractions, no cervical change on serial examinations, lower abdominal discomfort)

Front 11

The descent of the fetal head into the pelvis and the changing contour of the abdomen late in pregnancy is termed

Back 11

lightening

Front 12

Frequent urination found in late pregnency is the result of

Back 12

pressure on the bladder from the enlarging gravid uterus

Front 13

With lightening, a patient may notice

Back 13

all of the above (increased urinary frequency, increased ease of respiratory effort, a flatter upper abdomen)

Front 14

Which of the following is NOT an indication that a patient in late pregnancy should come to the hospital for evaluation?

Back 14

Regular contractions 15 to 20 min apart is not an indication to come to the hospital
(go to hospital if: sudden gush of fluid, continuing gradual leakage of fluid, vaginal bleeding, decreased fetal movement)

Front 15

The term "fetal lie" is defined as the

Back 15

relationship of the long axis of the fetus with the maternal long axis

Front 16

Presentation is determined by the

Back 16

portion of the fetus lowest in the birth canal

Front 17

Position is defined as

Back 17

relationship of the fetal presenting part to the right and left side of the maternal pelvis

Front 18

Leopold maneuvers are used to establish all of the following EXCEPT

Back 18

fetal gender
(Leopold maneuvers used to establish fetal lie, fetal presentation, and fetal position)

Front 19

The descent of the presenting part is identified by with Leopold maneuver?

Back 19

Third maneuver

Front 20

The location of small parts is determined by which Leopold maneuver?

Back 20

Second maneuver

Front 21

Determining what occupies the fundus is accomplished by what Leopold maneuver?

Back 21

First maneuver

Front 22

Identifying the cephalic prominence is accomplished by what Leopold maneuver?

Back 22

Fourth maneuver

Front 23

The most common fetal lie found during early labor is

Back 23

longitudinal

Front 24

The most common fetal presentation found in early labor is

Back 24

vertex

Front 25

The effacement of a patient in early labor with the cervix approximately 1 cm in length and 1 cm dilated is

Back 25

50% effacement

Front 26

The turning of the fetal head toward the sacrum is termed

Back 26

anterior asynclitism

Front 27

The station of a patient in labor with the presenting part (vertex) at the level of the ischial spines is

Back 27

0

Front 28

At 0 station, where is the biparietal diameter of the fetal head in relation to the pelvic inlet?

Back 28

It has passed below the pelvic inlet

Front 29

The clinical significance of the fetal head presenting at 0 station is that the biparietal diameter of the fetal head has negotiated the

Back 29

pelvic inlet

Front 30

Cervical effacement related to

Back 30

the degree of cervical thinning

Front 31

The first stage of labor is best described as the

Back 31

onset of labor to full cervical dilation

Front 32

The second stage of labor is best described as the

Back 32

complete dilation of the cervix to delivery of the infant

Front 33

The third stage of labor is best described as the

Back 33

delivery of the infant to the delivery of the placenta

Front 34

The fourth stage of labor is best described as the

Back 34

period extending up to 2 hours after delivery of the placenta

Front 35

The active phase of the first stage of labor is generally defined to begin when the cervix is how dilated?

Back 35

4 cm dilated - active stage of labor begins

Front 36

The vertex presentation occurs in approximately what percent of term?

Back 36

95%

Front 37

Which of the following terms describes the cardinal movement of labor that allows the smaller diameter of the fetal head to present to the maternal pelvis?

Back 37

Flexion

Front 38

Which of the following terms describes the movement of the fetal head as it reaches the introitus?

Back 38

Extension of the fetal head

Front 39

Which of the following describes the movement of the fetal head to "face forward" relative to the shoulders?

Back 39

External rotation

Front 40

Descent is fetal movement in labor defined as

Back 40

movement of the presenting part through the birth canal

Front 41

The latent phase of stage one labor in nulliparas has a mean duration of

Back 41

6.5 hours

Front 42

The active phase of stage one labor in nulliparas has a mean duration of

Back 42

4.5 hours

Front 43

The latent phase of stage one labor in multiparas has a mean duration of

Back 43

5.0 hours

Front 44

The active phase of stage one in multiparas has a mean duration of

Back 44

2.5 hours

Front 45

The second stage of labor in multiparas has a mean duration of

Back 45

0.5 hours

Front 46

All of the following are part of the examination after spontaneous rupture of the membranes EXCEPT

Back 46

Measurement of the pH of the fluid
(Exam after SPOM - exam of fluid for blood, exam of fluid for meconium, auscultation or measurement of the fetal heart rate)

Front 47

During the active phase of labor, if electronic fetal monitoring is not used, the fetal heart rate should be auscultated every

Back 47

15 minutes

Front 48

During the second stage of labor in the absence of electronic fetal monitoring, fetal heart rate auscultation should be performed after

Back 48

each uterine contraction

Front 49

An external tocodynamometer provides information about

Back 49

contraction frequency

Front 50

The sensory nerves from the lower birth canal and perineum enter the spinal cord at

Back 50

S2 through S4

Front 51

Epidural anesthesia is best used to provide

Back 51

anesthesia for the active phase of labor and delivery

Front 52

Spinal anesthesia is best used to provide

Back 52

short-term anesthesia for vaginal or abdominal delivery

Front 53

Pudendal anesthesia or block is best used to provide

Back 53

perineal anethesia for vaginal delivery

Front 54

Which of the following anesthetic techniques is associated with maternal aspiration?

Back 54

General anesthesia

Front 55

Which of the following is an associated maternal risk when spinal anesthesia is used?

Back 55

all of the above (hypotension, loss of desire to push, headache)

Front 56

Maternal aspiration syndrome is a particularly significant risk of general anesthesia in obstetric cases because

Back 56

of decreased gastrointestinal function during labor

Front 57

The major cause of maternal mortality from obstetrical anesthesia is

Back 57

aspiration of vomitus

Front 58

The most common result of compression of the fetal head during labor is

Back 58

molding

Front 59

Outlet forceps during delivery should best be used when

Back 59

the fetal skull at perineal floor, scalp visible, anteroposterior, righ occiput anterior to left occiput anterior (45 degrees)

Front 60

A low forceps delivery should best be used when

Back 60

the leading edge of the skull is beyond +2 station

Front 61

The second stage of labor in nulliparas has a mean duration of

Back 61

1.0 hours

Front 62

A midforceps delivery should best be used when

Back 62

the fetal head is engaged and the leading edge of the skull is above +2 station

Front 63

Forceps may be used to

Back 63

all of the above (rotate the fetal head, augment maternal voluntary pushing efforts, and control delivery of fetal head)

Front 64

The usual postpartum blood loss in a vaginal delivery is

Back 64

500 mL

Front 65

What percent of patients will undergo spontaneous labor and delivery between 37 and 42 weeks?

Back 65

85%

Front 66

First-degree vaginal laceration at birth

Back 66

involves the vaginal mucosa and perineal skin

Front 67

Second-degree vaginal laceration at birth

Back 67

involves underlying fascia or muscle but not rectal sphincter or rectal mucosa

Front 68

Third-degree vaginal laceration at birth

Back 68

extends through the rectal sphincter but not into the rectum

Front 69

Fourth-degree vaginal laceration at birth

Back 69

extends into the rectal mucosa

Front 70

Compared with extension of a mediolateral episiotomy, what is the risk of extension of a midline episiotomy?

Back 70

midline episiotomy GREATER RISK extension

Front 71

During delivery of the fetal head, the likelihood of laceration or extension of episiotomy is decreased by performance of

Back 71

Ritgen maneuver

Front 72

Which of the following is NOT a sign of placental separation?

Back 72

There is decreased sensation of pressure is NOT a sign
(signs of placental separation - the uterus rises in abdomen to become globular in shape, there is a gush of blood, there is an apparent "lengthening" of the umbilical cord

Front 73

It is customary to wait approximately how many minutes for spontaneous extrusion of the placenta?

Back 73

30 minutes

Front 74

Obstetric cervical lacerations are most commonly discovered at what "o-clock" during potpartum cervical inspection?

Back 74

3 and 9 o-clock

Front 75

The maternal mortality rate associated with cesarean delivery is how many times that of a vaginal birth?

Back 75

Two to four

Front 76

Postpartum uterine hemorrhage occurs in approximately what percent of patients?

Back 76

1%

Front 77

Vaginal examination of a patient in early labor finds the presenting part (vertex) to be at the level of the ischial spines. The station is reported as

Back 77

0