Obgyn Ch 7 Abnormal Labor

Front 1

Which of the following statements about prolapse of the umbilical cord is INCORRECT?

Back 1

Incorrect - Manual replacement of the cord is indicated when the presenting part is not engaged in the pelvis (Correct - it occurs in approx 0.5% patients, it occurs more frequently in patients of high parity, it most frequently occurs in breech presentation, with twins, and in the presence of polyhydramnios, and it is associated with an increased perinatal mortality)

Front 2

Which of the following is NOT associated with uterine rupture?

Back 2

Amniocentesis
(uterine ruputure is associated with previous c-section, myomectomy, administration of oxytocin, and difficult forceps delivery)

Front 3

Older gravidas have an increased incidence of

Back 3

all of the above (uterine inertia, malpresentation, and hypertension)

Front 4

The breech hydrocephalus is best managed by

Back 4

cesarean delivery

Front 5

Abnormal labor, or dystocia, can result from

Back 5

all of the above (anatomic anomalies of the fetus, anatomic anomalies of the maternal body pelvis, anatomic anomalies of the uterus, and functional abnormalities of the uterus)

Front 6

No progress from the latent to the active stage of labor in a nullipara is defined as prolonged latent phase if it lasts more than how many hours?

Back 6

> 20 hours

Front 7

Protraction disorder is an abnormal labor pattern related to

Back 7

prolonged active phase of labor

Front 8

Arrest disorder is an abnormal labor pattern related to

Back 8

secondary arrest of dilatation

Front 9

Cervical dilation that proceeds at less than 1.2 cm/hr (for a nulligravida) would be classified as

Back 9

a protraction disorder

Front 10

A situation where there has been no descent of the presenting part for over 1 hour during the second stage of labor would be classified as

Back 10

an arrest disorder

Front 11

Which of the following provides a quantitative measurement of the strength of uterine contractions?

Back 11

Intrauterine pressure catheter

Front 12

For a labor pattern to be considered optimal, contractions must generate a maximum intrauterine pressure of approximately how many mm Hg?

Back 12

50 to 60 mm Hg

Front 13

The incidence of shoulder dystocia and the need for cesarean delivery increase markedly if the fetus has an estimated weight of at least

Back 13

4,500 g

Front 14

Which of the following typically converts to either a vertex or face presentation?

Back 14

Brow

Front 15

What is the frequency of brow presentation?

Back 15

1 in 3,000

Front 16

What is the frequency of face presentation?

Back 16

1 in 600

Front 17

Which of the following usually resolves spontaneously as labor continues?

Back 17

Compound presentation

Front 18

Causes of dystocia may include

Back 18

all of the above (a contracted bony maternal pelvis, a distended bladder or colon, an adnexal mass, and a uterine leiomyomata)

Front 19

Which of the following is appropirate to use for the augmentation of labor?

Back 19

Oxytocin

Front 20

In a primigravid patient, the active phase of labor is defined as prolonged if it lasts longer than

Back 20

12 hours

Front 21

In multiparous patients, the active phase is defined as prolonged if it lasts

Back 21

6 hours

Front 22

There has been secondary arrest of dilation when cervical dilation during the active phase of labor stops for as least

Back 22

2 hours

Front 23

What is the Bishop's score for the following findings: a dilation of 1 to 2 cm, 60% effacement, a cephalic part of -1 station, and a soft cervix that is midposition?

Back 23

7

Front 24

There is a significant likelihood that induction has failed if the Bishop's score falls below

Back 24

4 points

Front 25

The prolonged latent phase in labor may be managed by

Back 25

all of the above (rest, augmentation with pitocin, and amniotomy)

Front 26

Which of the following is NOT a risk to the fetus from prolonged labor?

Back 26

Hemorrhage is NOT a risk to fetus from prolonged labor
(prolonged labor - increased risk of sepsis, subdural hematoma, and delivery associated trauma)

Front 27

Meconium aspiration syndrome is associated with

Back 27

All of the above (prolonged labor, postdates pregnancy, intrauterine growth restriction, and chronic maternal hypertension)

Front 28

What percent of singleton term deliveries are breech presentations?

Back 28

3%

Front 29

Vaginal delivery of the term breech is generally avoided when the fetus weighs less than

Back 29

2,000 g

Front 30

Which of the following is NOT a selection criterion for external cephalic version?

Back 30

Presenting part in the pelvis is NOT a criterion for ECV
(criterion for external cephalic version are: normal fetus, reassuring fetal heart rate tracing, no uterine surgical scars, and adequate amniotic fluid)

Front 31

All of the following are risks of external cephalic version EXCEPT

Back 31

Sepsis is not a risk of ECV
(risks of ECV include: uterine rupture, cord accident, placental abruption, and premature rupture of the membranes)

Front 32

Cesarean delivery is required in what percent of term breeches because of hyperextension of the fetal head?

Back 32

5%

Front 33

Outlet forceps-assisted vaginal delivery is appropriately considered with the fetus at what station?

Back 33

At the perineal floor

Front 34

Low forceps-assisted vaginal delivery occurs with the fetus at what station?

Back 34

At the +2 station

Front 35

Midforceps-assisted vaginal delivery is defined with the fetus at what station?

Back 35

Above the +2 station

Front 36

Uterine contractions occurring at irregular intervals is characteristic of

Back 36

false labor

Front 37

Sedation provides relief from discomfort of uterine contractions in

Back 37

false labor

Front 38

Uterine contractions of unchanging intensity are characteristic of

Back 38

false labor

Front 39

Abdominal but not back discomfort with contractions is characteristic of

Back 39

false labor

Front 40

Vasa previa is a

Back 40

contraindication to induction of labor

Front 41

Prior classic uterine incision is a(n)

Back 41

contraindication to induction of labor

Front 42

Premature rupture of membranes at term is a(n)

Back 42

indication for induction of labor

Front 43

Intrauterine fetal demise is a(n)

Back 43

indication for induction of labor

Front 44

Cord presentation is a(n)

Back 44

contraindication to induction of labor

Front 45

Abnormal fetal lie is a(n)

Back 45

contraindication for induction of labor

Front 46

Chorioamniotitis is a(n)

Back 46

indication for induction of labor

Front 47

Active genital herpes infection is a(n)

Back 47

contraindication to induction of labor

Front 48

The delivery of the fetal head in the assisted breech delivery is often facilitated with what type of forceps?

Back 48

Kielland