Normal and abnormal labor part 1


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Undergraduate course lectures in Obstetrics&Gynecology .Faculty of medicine,Zagazig University .Prepared by DR Manal Behery

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Normal and abnormal labor part 1

  1. 1. A-between 37 and 42 weeks from the last menstrual periodB- Before 37 weeks gestationC-After 42 weeks gestationD- After 24 weeks gestation ANSWER A
  2. 2.  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)
  3. 3. Preterm labour : Preterm labor is that occurringbefore 37 weeks of gestational age.Postdate pregnancy : Postdate pregnancy occursafter 42 weeks .
  4. 4. A. – longitudinal axis of the fetus in relation to the oblique axis of the maternal uterusB. longitudinal axis of the fetus in relation to the transverse axis of the maternal uterusC. longitudinal axis of the fetus in relation to the long axis of the maternal uterusD. longitudinal axis of the fetus in relation to the long axis of the maternal pelvis ANSWER C
  5. 5.  Logitudinal transverse oblique
  6. 6. A. Relates to right or left side of maternal pelvisB. presenting or is the closest in proximity to the birthing canalC. Ralated to long axis of motherD. First enter the pelvic cavityE. First felt by vaginal examination ANSWER B
  7. 7.  the part of the fetus that is presenting or is the closest in proximity to the birthing canal Vertex Breech
  8. 8. A. position is either cephalic or breechB. attitude is either flexion ,OR deflexionC. position is the relationship of a landmark on the presenting part to the right or left side of the pelvisD. Position is either oblique lognitudinal or treasverseE .Attuide is landmark on presenting part that determine position ANSWER C
  9. 9.  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.
  10. 10. Position, attitude of the fetus in labour
  11. 11. A. Passage of bloody showB. Occurance of uterine contractionC. Excessive fetal movementD. Cervical dilation and effacementE. Gush of vaginal fluid ANSWER D
  12. 12.  cervical change Effacemant :is shortening of the cervical canal (from a length of 3 cm to a circular aperture.
  13. 13. A-Occur at regular intervalsB-Intervals get gradually smallerC-Intensity increasesD-Pain felt in the back and abdomenE-Pain stop with sedationF-Cervix dilate ANSWER E
  14. 14. A-Occur At Irregular IntervalsB-Intensity doesnt changeC-Pain primarily in lower abdomenD-Pain usually relieved with sedationE-Cervix dilateANSWER E
  15. 15. A-Relaxion after uterine contractionB-Intensity of uterine contraction in upper and lower segmentC-The myometrium of the upper uterine become shorter after contractionD- the pacemaker in the right cornu of the uterus ANSWER C
  16. 16. A. 5-1-1: contractions approximately every 5 minutes lasting for 1 min for 1 hourB. Sudden gush of fluid from the vagina or a constant leakage/wetnessC. Vaginal bleeding(bloody show)D.Decrease in fetal movement(kick counts should be 10 kicksin 2 hours)E All of the above ANSWER E
  17. 17. A. Dilation ,presention and effacmentB. Effacement ,station and positionC. Dilation ,effacment ,and stationD. Station ,dilation and descentE. Presentation ,station ,and dilation ANSWER C
  18. 18.  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
  19. 19.  -3: 3 cm above the ischial spines 0: at the ischial spines, engaged +3: 3 cm below the ischial spines
  20. 20. Engagement and station of the fetus in labour
  21. 21. A. First stage of labor ends with delivery of fetusB. Second stage of labor is divded into latent and active phaseC. Third stage of labor lasts one hoursD.Third stage of labor begins immediatelyafter delivery of the infant and ends with placental delivery ANSWER D
  22. 22. • -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
  23. 23.  2ND -complete cervical dilation to delivery of the infant 3rd -begins immediately after delivery of the infant and ends with delivery of the placenta
  24. 24. A. Relfied by maternal position on left sideB. Compression of fetal head mediated by vagusC. Caused by umbilical cord compressionD. Is not worrisome if non recurrentE. Is mostly due to placental insufficancy ANSWER E
  25. 25. A. Variability is the result of push pull of sympathetic and para sympatheticB. Acceleration is > 2 elevation of baslind FHR above 25 pbm in 30 min periodC. Acceleration with absent variability is reassuring traceD. Moderate variability and lasck of accleration is worrisome ANSWER A
  26. 26. A. 50% or more of contractionB. All of contractionC. 25% or more of contractionD. One out of tree contraction ANSWER A
  27. 27. 2. Fetal monitoring 2.2 Baseline rate, HR variability, accelerations, decelerations
  28. 28.  A-engagement B-flexion C-descent D-internal rotation E-extension F-Backword rotation ANSWER F
  29. 29. A-Gush of bloodB-Lengthening of umbilical cordC-Rebound of the uterusD-All of the aboveANSWER D
  30. 30.  -Expectant Management -gentle traction while applying suprapubic pressure to avoid uterine inversion
  31. 31. A-IV oxytocin afterdelivery of ant shoulder.B-Controlled cord tractionC- Suprapubic massageD-Uterine massage ANSWER C
  32. 32. A- Dilation and intensity of contractionB-Dilation and effecmantC-Dilation and descentD,Frequancy of contraction and descentE- All of the above ANSWER C
  33. 33. PARTOGRAM - Friedman
  34. 34.  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
  35. 35. THANK YOU