NM704 FINAL EXAM| QUESTIONS WITH 100% CORRECT ANSWERS| LATEST UPDATE 100%
VERIFIED
What is the current criteria for normal duration of the second stage per ACOG? has not been
identified
Prolonged 2nd stage labor: nullip and multip Nullip: >3 hr w/o epidural, >4 hr w/ epidural
Multip: >2 hr w/o epidural, >3 hr w/ epidural
Longer durations of second stage may be appropriate as long as progress is being
documented
Which birthing positions are associated with more trauma/2nd degree lacs? Lithotomy and
squatting
Hands on (flexion of fetal head and guarding perineal body) evidence lower rates of perineal
and sphincter tears
Mediolateral epis is less likely to result in 3rd or 4th degree lac compared to midline epis
Higher postpartum pain is associated with which epis mediolateral
Third stage of labor definition begins with birth of baby
ends with delivery of placenta
Central separation "shiny"
, membranes are inverted d/t increased placental surface area compared to the placental
attachment site
more common
Peripheral separation "dirty"
buckles at the edge from the margin
accompanied by more visible bleeding
the maternal surface (rough, textured side) is the 1st part seen at vaginal opening
amniotic sac does not invert, trails behind placenta
signs of placental separation new trickle/gush
lengthening of cord
uterus changes shape (discoid -> globular)
fundus rises slightly
Expectant management of 3rd stage of labor evidence No increased blood loss compared w/
AMTSL general population
No increased r/o PPH compared with AMTSL general population
For moms with RF for PPH, _________ should be the recommended approach for management
of 3rd stage AMTSL
Active management of 3rd stage of labor evidence decreased r/o PPH
less overall blood loss
less PP anemia
less need for uterotonics
VERIFIED
What is the current criteria for normal duration of the second stage per ACOG? has not been
identified
Prolonged 2nd stage labor: nullip and multip Nullip: >3 hr w/o epidural, >4 hr w/ epidural
Multip: >2 hr w/o epidural, >3 hr w/ epidural
Longer durations of second stage may be appropriate as long as progress is being
documented
Which birthing positions are associated with more trauma/2nd degree lacs? Lithotomy and
squatting
Hands on (flexion of fetal head and guarding perineal body) evidence lower rates of perineal
and sphincter tears
Mediolateral epis is less likely to result in 3rd or 4th degree lac compared to midline epis
Higher postpartum pain is associated with which epis mediolateral
Third stage of labor definition begins with birth of baby
ends with delivery of placenta
Central separation "shiny"
, membranes are inverted d/t increased placental surface area compared to the placental
attachment site
more common
Peripheral separation "dirty"
buckles at the edge from the margin
accompanied by more visible bleeding
the maternal surface (rough, textured side) is the 1st part seen at vaginal opening
amniotic sac does not invert, trails behind placenta
signs of placental separation new trickle/gush
lengthening of cord
uterus changes shape (discoid -> globular)
fundus rises slightly
Expectant management of 3rd stage of labor evidence No increased blood loss compared w/
AMTSL general population
No increased r/o PPH compared with AMTSL general population
For moms with RF for PPH, _________ should be the recommended approach for management
of 3rd stage AMTSL
Active management of 3rd stage of labor evidence decreased r/o PPH
less overall blood loss
less PP anemia
less need for uterotonics
