OB WSU Exam 1 fully solved and updated.

Fetal Presentation - answer-Part of the fetus in the birth canal (i.e. head, buttocks) Best vertex position - answer-Suboccipitobregmatic Fetal Attitude - answer-relationship of fetal parts to one another Normal fetal attitude - answer-moderate flexion of head, flexion of the arms onto the chest, flexion of legs onto abdomen. Fetal Lie - answer-the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother Cardinal Movements Definition - answer-Specific body changes the fetus undergoes to pass through birth canal. Cardinal Movements (list) - answer-1. Descent 2. Flexion - of fetal chin 3. Internal Rotation - Left to Right 4. Extension - Of fetal head, hardest part 5. External Rotation - anterior shoulder is born first Three phases of a contraction - answer-Increment: building up (longest) Acme: peak Decrement: uterus relaxing Fetal Station - answer-Location of the presenting part in relation to the midpelvis or ischial spines; expressed as cm above or below the spines; station 0 is engaged, station -2 is 2 cm above the ischial spines Hydrostatic pressure - answer-When amniotic fluid collects beneath the fetal head and pushes on the cervix to help dilate. First stage of labor - answer-Begins with the onset of true labor and ends when the cervix is completely dilated at 10 cm Second Stage of Labor - answer-Begins with complete dilation of cervix and ends with delivery of baby Third stage of labor - answer-Begins with birth of infant & ends with delivery of placenta. Fourth stage of labor - answer-begins with the delivery of the placenta and includes at least the first 2 hours after birth - uterus contracts to control bleeding First stage of labor - latent phase - answer-Begins with the onset of regular Uterine contractions Mild and short contraction (Lasts about 30-45 seconds) Effacement occurs Dilation to 0-3 cm Can still walk and talk Avoid giving analgesia at this time First Stage of Labor - Active Phase - answer-Dilation progresses from 4-7 cm Stronger and longer UC (lasting about 60 seconds) Frequency of contractions is usually about every 2-3 minutes Painful Can't talk through the contractions - anxious, needs support Good time to give analgesics First Stage of Labor - Transitional Phase - answer-Dilation from 8-10 cm Strong and long UC (60-90 seconds) Frequency of every 1.5-2 minutes Usually a rapid phase of labor - increased bloody show Full dilation and complete effacement occur Very emotional, total loss of control, anxiety, anger. May begin to feel the urge to push, significant rectal pressure VIP monitoring in second stage - answer-Fetal heart rate due to decreased maternal-fetal oxygenation Average blood loss during labor - answer-250-500 ml When is EFM used - answer-If pitocin is used, epidural is used, high risk pregnancy, or if fetus looks questionable. Variability - answer-Fluctuations in FHR above and below the baseline looked over 10 mins. Determined by STABILITY of CNS Periodic Patterns - answer-Associated with uterine contractions Episodic patterns - answer-NOT associated with contractions Late decels - answer-placental problem leading to decreased blood flow and oxygenation What are late decels caused by - answer-Hypotension after epidural, uterine tachysystole from pitocin, maternal HTN, diabetes, etc. Early decels - answer-Fetal cerebral blood flow is reduced, vagal nerve is stimulated and FHR slows Variable decels - answer-blood flow is limited due to cord compression VEAL CHOP - answer-V- Variable C- Cord Compression E- Early Decels H- Head Compression A- Accelerations O - OK L-Late Decels P - Placenta Coupling - answer-Contraction starts to subside and begins again without break. When is coupling seen - answer-OP positioned baby, full bladder Fetal Development Week 4 - answer-Fetal heart rate begins to beat Fetal Development Week 8/9 - answer-All body organs are formed Fetal Development Weeks 8-12 - answer-FHR can be heard by doppler Fetal Development Week 16 - answer-Baby's sex is seen, thin fetus that looks like a baby, meconium becomes to collect. Fetal Development Week 20 - answer-Vernix caseosa covers baby, lanugo covers baby, head hair, regular schedule of sleeping, sucking and kicking Fetal Development Week 24 - answer-Fetal respiratory movement begins, activity increases, weighs 780 g Fetal Development Week 28 - answer-Eyes open and close, baby can breathe, surfactant is formed, baby is 2/3 final length Fetal Development Week 32 - answer-Fingernails and toenails, subcut fat is laid down, baby is less red and wrinkled. Fetal Development Week 38+ - answer-Baby fill uterus, gets antibodies from mom GTPAL - answer-Gravida, Term (37), Preterm (20-37), Abortions (20), Living