normal and abnormal labor part 1
DESCRIPTION
Undergraduate course lectures in Obstetrics&Gynecology .Faculty of medicine,Zagazig University .Prepared by DR Manal BeheryTRANSCRIPT
A-between 37 and 42 weeks from the last menstrual period
B- Before 37 weeks gestation
C-After 42 weeks gestation
D- After 24 weeks gestation
ANSWER A
Normal labour is the process by which contractions of the gravid uterus expel the fetus and the other products of conception between 37 and 42 weeks from the last menstrual period (Term Delivery)
Preterm labour : Preterm labor is that occurring before 37 weeks of gestational age.
Postdate pregnancy : Postdate pregnancy occurs after 42 weeks .
A. – longitudinal axis of the fetus in relation to the oblique axis of the maternal uterus
B. longitudinal axis of the fetus in relation to the transverse axis of the maternal uterus
C. longitudinal axis of the fetus in relation to the long axis of the maternal uterus
D. longitudinal axis of the fetus in relation to the long axis of the maternal pelvis
ANSWER C
Logitudinal transverse oblique
A. Relates to right or left side of maternal pelvis
B. presenting or is the closest in proximity to the birthing canal
C. Ralated to long axis of mother
D. First enter the pelvic cavity
E. First felt by vaginal examination
ANSWER B
the part of the fetus that is presenting or is the closest in proximity to the birthing canal
Vertex Breech
A. position is either cephalic or breech
B. attitude is either flexion ,OR deflexion
C. position is the relationship of a landmark on the presenting part to the right or left side of the pelvis
D. Position is either oblique lognitudinal or treasverse
E .Attuide is landmark on presenting part that determine position
ANSWER C
The position of the baby is the relationship of a landmark on the presenting part to the right or left side of the pelvis i.e. LOA, LOP, LOT, OP, OA, ROA, ROP, ROT.
The attitude describes the posture of the fetus i.e. flexion, deflexion, extension.
Position, attitude of the fetus in labour
A. Passage of bloody show
B. Occurance of uterine contraction
C. Excessive fetal movement
D. Cervical dilation and effacement
E. Gush of vaginal fluid ANSWER D
cervical change Effacemant :is shortening of the cervical canal
(from a length of 3 cm to a circular aperture.
A-Occur at regular intervals
B-Intervals get gradually smaller
C-Intensity increases
D-Pain felt in the back and abdomen
E-Pain stop with sedation
F-Cervix dilate ANSWER E
A-Occur At Irregular Intervals
B-Intensity doesn't change
C-Pain primarily in lower abdomen
D-Pain usually relieved with sedation
E-Cervix dilate
ANSWER E
A-Relaxion after uterine contraction
B-Intensity of uterine contraction in upper and lower segment
C-The myometrium of the upper uterine become shorter after contraction
D- the pacemaker in the right cornu of the uterus
ANSWER C
A. 5-1-1: contractions approximately every 5 minutes lasting for 1 min for 1 hour
B. Sudden gush of fluid from the vagina or a constant leakage/wetness
C. Vaginal bleeding(bloody show)
D.Decrease in fetal movement (kick counts should be 10 kicks in 2 hours)E All of the above
ANSWER E
A. Dilation ,presention and effacment
B. Effacement ,station and position
C. Dilation ,effacment ,and station
D. Station ,dilation and descent
E. Presentation ,station ,and dilation
ANSWER C
1. Dilation: estimation of the diameter of the cervical opening at the level of the internal os
2. Effacement: thinning of the cervix expressed as a percentage of thinning from the perceived uneffaced state
3. Station: the level of the fetal presenting part in the birth canal in relation to the ischial spines
-3: 3 cm above the ischial spines0: at the ischial spines, engaged+3: 3 cm below the ischial spines
Engagement and station of the fetus in labour
A. First stage of labor ends with delivery of fetus
B. Second stage of labor is divded into latent and active phase
C. Third stage of labor lasts one hours
D.Third stage of labor begins immediately
after delivery of the infant and ends with placental delivery
ANSWER D
• -interval between the onset of labor and full cervical dilation
*latent: cervical effacement and early dilation, usually the woman spends most of the latent phase of labor at home*active: more rapid cervical dilation occurs, usually begins around 4 cm dilated
2ND -complete cervical dilation to delivery of the infant
3rd -begins immediately
after delivery of the infant
and ends with delivery of
the placenta
A. Relfied by maternal position on left side
B. Compression of fetal head mediated by vagus
C. Caused by umbilical cord compression
D. Is not worrisome if non recurrent
E. Is mostly due to placental insufficancy
ANSWER E
A. Variability is the result of push pull of sympathetic and para sympathetic
B. Acceleration is > 2 elevation of baslind FHR above 25 pbm in 30 min period
C. Acceleration with absent variability is reassuring trace
D. Moderate variability and lasck of accleration is worrisome
ANSWER A
A. 50% or more of contraction
B. All of contraction
C. 25% or more of contraction
D. One out of tree contractionANSWER A
2.2 Baseline rate, HR variability, accelerations, decelerations
2. Fetal monitoring
A-engagementB-flexionC-descentD-internal rotationE-extensionF-Backword rotation
ANSWER F
A-Gush of blood
B-Lengthening of umbilical cord
C-Rebound of the uterus
D-All of the above
ANSWER D
-Expectant Management-gentle traction while applying suprapubic pressure to avoid uterine inversion
A-IV oxytocin after
delivery of ant shoulder.
B-Controlled cord traction
C- Suprapubic massage
D-Uterine massage
ANSWER C
A- Dilation and intensity of contraction
B-Dilation and effecmant
C-Dilation and descent
D,Frequancy of contraction and descent
E- All of the above
ANSWER C
PARTOGRAM - Friedman
Nulliparous: first stage latent-6.5 hours, first stage active-4.5 hours, second stage-1 hour
Multiparous: first stage latent-5 hours, first stage active-2.5 hours, second stage-0.5 hour
THANK YOU