ANTEPARTUM AND LABOR/DELIVERY
QUESTIONS AND CORRECT ANSWERS
Epidural (block) - Answer-Injection of local anesthetic drug into the epidural space.
Blocks transmission of pain impulses to the brain
Hypotension during pregnancy - Answer-When the flat supine position is assumed and
the uterus presses on the vena cava, the increasing size of the uterus can cause poor
venous return and result in supine hypotension syndrome
Back labor - Answer-Is related to the posterior presentation of the fetus.
"hands and knees" position good for in labor
Preclampsia - Answer-An abnormal condition encountered during pregnancy or shortly
after delivery characterized by high blood pressure, edema, and proteinuria, but with no
convulsions or coma
Cerclage - Answer-Suturing the cervix to prevent it from dilating prematurely during
pregnancy, thus decreasing the chance of a spontaneous abortion. The sutures are
removed prior to delivery
Incompetent cervix - Answer-Failure of the cervix to remain closed until the fetus is
mature enough to survive outside the uterus
Placenta previa - Answer-Is the implantation of the placenta in the lower uterine
segment rather than the central or upper portion of the uterine wall. During labor, the
fetus normally leaves the uterus before the placenta is delivered. However, if the
placenta implants in the lower uterine segment, it can obstruct delivery of the fetus.
There are three degrees of placenta previa
Gestational diabetes - Answer-Develops during pregnancy and usually goes away after
the baby is born; At risk for type 2 diabetes later in life
Type 1 diabetes in pregnancy - Answer-Usually caused by a pathological disorder of the
pancreas resulting in an insulin deficiency
Type 2 diabetes in preganacy - Answer-Usually caused by insulin resistance; usually
has a strong genetic disposition
Ectopic pregnancy - Answer-Implantation of the fertilized egg outside the uterine cavity,
often in the tube, ovary, or (rarely) the abdominal cavity
Non-stress test - Answer-Used to determine fetal well being in high risk pregnancy and
especially useful in postmaturity (notes response of fetus to own movements);
, A healthy fetus will usually response to its own movement by means of an FHR
acceleration of 15 beats, lasting for at least 15 seconds after the movement, twice in a
20 minute period;
The fetus that response with the 15/15 acceleration is considered reactive and healthy
Terbutaline - Answer-(Brethine) given to stop uterine contractions.
Propranolol should be available to counter the effects of the drug
PIH - Answer-Pregnancy Induced Hypertension
Betamethasone - Answer-Celestone - Corticosteroid (Immunosuppressive agent)
Is given to stimulate fetal lung maturation In patients that are in preterm labor between
28 and 32 weeks' gestation if the labor can be inhibited for 48 hours.
Oxytocin - Answer-A hormone released by the posterior pituitary that stimulates uterine
contractions during childbirth and milk ejection during breastfeeding.
--Drugs used to stimulate labor, uterine contractions, milk let down, and to control
uterine hemorrhage:
Breech presentation - Answer-A common abnormality of delivery in which the fetal
buttocks or feet present first rather than the head
Fundal height - Answer-What is assessed on a physical exam to determine due date.
Once it's above the level of symphysis pubis, it is between 12-14 weeks; at the
Umbilicus it is about 20 weeks; Rises 1cm per week until 36th week
Forceps delivery - Answer-2 double-crossed, spoonlike articulated blades are used to
assist in the delivery of the fetal head.
Facial nerve palsy of CN 7 is associated w/subdural hematoma
Assess infant for bruising or abrasions at the site of blade application, facial palsy,
subdural hematoma, document findings
Vacuum extraction - Answer-Technique that uses suction to help the doctor move the
baby down the birth canal as the mother pushes.
--Vacuum extraction applies suction to the fetal head. 68% of all operative vaginal
births. Composed of a soft suction cup attached to a suction bottle by tubing. Make sure
no vaginal tissue is trapped under the cup. The fetal head should descend with each
contraction. The longer the duration of suction, the more likely the newborn will have
scalp injury.
Most MDs limit suction to 20 minutes. Most common indication: prolonged 2nd stage
labor or nonreassuring HR pattern. --Neonatal complications: scalp lacerations,
bruising, hematomas, hemorrhages, fractured clavicle, and death.
--Maternal complications: perineal trauma, edema, lacerations, pain, infection.
Presenting part must be vertex and 0 station or below. Auscultate FHR every 5 minutes.
QUESTIONS AND CORRECT ANSWERS
Epidural (block) - Answer-Injection of local anesthetic drug into the epidural space.
Blocks transmission of pain impulses to the brain
Hypotension during pregnancy - Answer-When the flat supine position is assumed and
the uterus presses on the vena cava, the increasing size of the uterus can cause poor
venous return and result in supine hypotension syndrome
Back labor - Answer-Is related to the posterior presentation of the fetus.
"hands and knees" position good for in labor
Preclampsia - Answer-An abnormal condition encountered during pregnancy or shortly
after delivery characterized by high blood pressure, edema, and proteinuria, but with no
convulsions or coma
Cerclage - Answer-Suturing the cervix to prevent it from dilating prematurely during
pregnancy, thus decreasing the chance of a spontaneous abortion. The sutures are
removed prior to delivery
Incompetent cervix - Answer-Failure of the cervix to remain closed until the fetus is
mature enough to survive outside the uterus
Placenta previa - Answer-Is the implantation of the placenta in the lower uterine
segment rather than the central or upper portion of the uterine wall. During labor, the
fetus normally leaves the uterus before the placenta is delivered. However, if the
placenta implants in the lower uterine segment, it can obstruct delivery of the fetus.
There are three degrees of placenta previa
Gestational diabetes - Answer-Develops during pregnancy and usually goes away after
the baby is born; At risk for type 2 diabetes later in life
Type 1 diabetes in pregnancy - Answer-Usually caused by a pathological disorder of the
pancreas resulting in an insulin deficiency
Type 2 diabetes in preganacy - Answer-Usually caused by insulin resistance; usually
has a strong genetic disposition
Ectopic pregnancy - Answer-Implantation of the fertilized egg outside the uterine cavity,
often in the tube, ovary, or (rarely) the abdominal cavity
Non-stress test - Answer-Used to determine fetal well being in high risk pregnancy and
especially useful in postmaturity (notes response of fetus to own movements);
, A healthy fetus will usually response to its own movement by means of an FHR
acceleration of 15 beats, lasting for at least 15 seconds after the movement, twice in a
20 minute period;
The fetus that response with the 15/15 acceleration is considered reactive and healthy
Terbutaline - Answer-(Brethine) given to stop uterine contractions.
Propranolol should be available to counter the effects of the drug
PIH - Answer-Pregnancy Induced Hypertension
Betamethasone - Answer-Celestone - Corticosteroid (Immunosuppressive agent)
Is given to stimulate fetal lung maturation In patients that are in preterm labor between
28 and 32 weeks' gestation if the labor can be inhibited for 48 hours.
Oxytocin - Answer-A hormone released by the posterior pituitary that stimulates uterine
contractions during childbirth and milk ejection during breastfeeding.
--Drugs used to stimulate labor, uterine contractions, milk let down, and to control
uterine hemorrhage:
Breech presentation - Answer-A common abnormality of delivery in which the fetal
buttocks or feet present first rather than the head
Fundal height - Answer-What is assessed on a physical exam to determine due date.
Once it's above the level of symphysis pubis, it is between 12-14 weeks; at the
Umbilicus it is about 20 weeks; Rises 1cm per week until 36th week
Forceps delivery - Answer-2 double-crossed, spoonlike articulated blades are used to
assist in the delivery of the fetal head.
Facial nerve palsy of CN 7 is associated w/subdural hematoma
Assess infant for bruising or abrasions at the site of blade application, facial palsy,
subdural hematoma, document findings
Vacuum extraction - Answer-Technique that uses suction to help the doctor move the
baby down the birth canal as the mother pushes.
--Vacuum extraction applies suction to the fetal head. 68% of all operative vaginal
births. Composed of a soft suction cup attached to a suction bottle by tubing. Make sure
no vaginal tissue is trapped under the cup. The fetal head should descend with each
contraction. The longer the duration of suction, the more likely the newborn will have
scalp injury.
Most MDs limit suction to 20 minutes. Most common indication: prolonged 2nd stage
labor or nonreassuring HR pattern. --Neonatal complications: scalp lacerations,
bruising, hematomas, hemorrhages, fractured clavicle, and death.
--Maternal complications: perineal trauma, edema, lacerations, pain, infection.
Presenting part must be vertex and 0 station or below. Auscultate FHR every 5 minutes.
