Chapter 13 - Labour and delivery

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elwoo4
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36778
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Chapter 13 - Labour and delivery
Updated:
2010-09-22 23:19:07
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Women\'s Health core curriculum
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Women's
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  1. N active labour is assoc w which of the following maternal physiological changes?
    A. Oliguria
    B. CO, BP and catecholamine secretion all rise
    C. CO and catecholamine secretion increase, bp falls
    D. HR, RR and CO are unchanged
    E. HR increase, RR increase, and peripheral vascular resistance decrease
    B.
    (this multiple choice question has been scrambled)
  2. Which one of these statements about analgesia in labour is correct?
    a. Epidural analgesia may be associated with a low-grade maternal pyrexia
    b. Nitrous oxide reduces uterine activity
    c. Epidural analgesia does not affect the rate of instrumental delivery
    d. Non-pharmalogical methods of pain relief such as baths, massage and continuous maternal support have not been shown to have any effect upon maternal pain scores
    e. One-to-one care in labour is assoc w an incr in analgesia requirements
    • a.
    • Epidural analgesia assoc w maternal motor blockade, need for continuous getal monitoring, possible maternal hypotn, loss of bladder sensation (catheter), incr rates of instrumental delivery, maternal fever
  3. Which one of these statement about N labour is correct?
    a. The average duration of the latent phase of labour is 2hrs.
    b. For the primigravida, adequate progress in the active phase of labour is cervical dilatation of 2cm/h
    c. the average duration for the active phase of labour for the multigravida is 10hrs
    d. The average duration of the second stage of labour for the nullipara without an epidural is 60 mins
    e. The purpose of the partograph is to record uterine contractions
    • 1st stage: onset to full cervical dilatation
    • - latent phase - effacement and dilatation (8hrs, 1 cm/hr for nulliparous, 1.5cm/hr for multiparous)
    • - active phase - from dilatation of 3cm progress of labour accelerates to min of 1cm dilatation per hour in nullipara (8hrs for nullipara, 6hrs for multipara)
    • 2nd stage: ful dilatation to delivery (nullipara: 60 or w epidural = 100mins, multipara: 20 or w epidural 60mins)
    • - phase one - descent of head until it reaches the levator ani muscle
    • - phase two - phase of active pushing
    • 3rd stage: delivery of placenta and membranes
    • Partograph is used to assess progress of labour
  4. Which one of these statement about prolonged labour is correct?
    a. The action line on the partogram provides a visual cue for abN progress of labour.
    b. An abN pelvis shape is the most likely reason for prolonged labour in the nullipara
    c. Failure of descent w progressively increasing caput and moulding is a feature of a N labour
    d. The use of oxytocin augmentation is similar for the nullipara and the multipara
    e. The most common cause of slow progress in a nullipara is inefficient uterine action
    • a,
    • Prolonged labour aetiology: multiple possible causes
    • maternal factors:
    • inefficient uterine action, factors affecting the fit between the pelvis and the fetal head.
    • fetal factors:
    • N sized fetus w unfavourable diamerter presenting, N sized fetus w compound presentation, large fetus, fetal abNities
  5. Which of the following statements about active Mx of labour are correct?
    a. The principle aim is to reducte the c-section delivery rate
    b. early amniotomy allows visualisation of the liguor and augments labour
    c. The action line on the partogram indicates a cervical dilatation rate of 2cm per hour
    d. The most likely reason for slow progress in a nulliparous labour is inefficient uterine action
    e. One-to-one care in labour has been shown to reduce the duratio nfo labour
  6. Which of these statements about operative delivery is correct?
    a. 5% of low-risk

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