Quiz: Normal Labor

Active management of third stage of labour involves

A A. Using a balloon tamponade to enhance uterine involution B B. Delivery of the cord by controlled cord traction with counter traction over the Supra pubic arca C C. Administration of 10 IU of Oxytocin IM on the anterior thigh within 2 minutes of delivery of the baby D D. Pelvic floor exercises (Kegel's exercise)

The following is not a landmark in the pelvic inlet

A A. The sacral promontory B B. Sciatic notches C C. The Ala of the sacrum D D. The pubic crest

The second stage of labor is defined as

A A. The interval from onset of contractions to the beginning of cervical dilation B B. The time from full cervical dilation to delivery of the fetus C C. The duration of maternal pushing efforts D D. The time from delivery of the fetus until delivery of the placenta

Fetal presentations and positions

A A. Attitude is the relation between the transverse axis of the fetus and the maternal spine B B. Vertex presentation includes cephalic, face, and brow presentation C C. Face presentation is more common than breech D D. The most common position is Left Occipito-anterior

5) Diagnosis of labour

A A. Cervical dilatation is the measurement of the external os B B. In fully effaced cervix cervical dilatation cannot be measured C C. Effacement is usually described as fingers or centimeters D D. in primigravida effacement occurs first, then dilatation

The sure diagnosis of onset of labor includes the following EXCEPT

A A. Engagement B B. Cervical dilatation C C. Formation of the bag of fore-waters D D. True labor pains

Internal rotation of the head takes place in the following pelvic plane

A a) Greatest pelvic dimension B b) Least pelvic dimension C c) Plane of inlet D d) Plane of outlet

The most important transverse diameter of the fetal head is

A a) Biparietal diameter B b) Suboccipito bregmatic diameter C c) Submento bregmatic diameter D d) Mento vertical diameter

The followings is sure evidence of 2nd stage of labor

A a) Full cervical dilatation B b) Rupture of the bag of fore water C c) Bearing down D d) Gush of blood

Advantage of a median episiotomy include the following EXCEPT

A A. Decreased anal sphincter injury B B. Less blood loss C C. Increased area of vaginal outlet D D. Greater ease of repair

During 3rd stage of labour, the following is NOT a sign of placental separation

A A. A gush of blood B B. Uterus rises in the abdomen C C. Uterus becomes flaccid D D. Supra pubic bulge is seen and felt

In managing first stage of normal labor

A a. Antibiotics are recommended B b. Bearing down is encouraged C c. Heavy sedation is given D d. Patient walking is allowed

Which of the following characterizes true labor

A a. Painless contractions with rupture of the membranes B b. Progressive cervical dilatation and effacement C c. Rhythmic lower abdominal pain D d. Rhythmic lower abdominal pain and backache

The greatest diameter of the normal fetal head is the

A a. Occipito frontal B b. Submento bregmatic C c. Suboccipito bregmatic D d. Suboccipito frontal

Fetal head is considered Just engaged when

A A. Passage of the lowermost part of the head through the pelvic inlet B B. Passage of the BPD through the pelvic inlet C C. Passage of the BPD through the level of ischial spines D D. Failure of the BPD to pass through the pelvic brim

Which statement describes the sequence of head delivery In normal labor

A a. Occiput-vertex-brow-face-chin B b. Chin-face-brow-vertex-occiput C c. Face-brow-vertex-occiput chin D d. Vertex-brow-lace-chin-occiput

The Brandt-Andrews maneuver refers to a method for

A a. Delivery of after coming head of breech B b. Internal Podalic Version C c. Delivery of placenta D d. Management of shoulder dystocia

Regarding episiotomy, all of the following is correct EXCEPT

A a. A generous episiotomy is required with wide sub pubic angle B b. Repair should take place in separate layers C c. Can cause vulval hematoma D d. Extension to the rectum is more common with midline type

The most important factor in determining the success of Induction of labor is

A a) Strength of contractions B b) Use of monitoring C c) Cervical ripening D d) Timing of artificial rupture of membranes

During normal labor internal rotation of the fetal head occurs in the following plane

A a) the plane of pelvic inlet B b) the plane of pelvic outlet C c) the plane of the greatest pelvic dimension D d) the plane of the least pelvic dimension

The largest longitudinal diameter of fetal skull is

A a) Sub occipito bregmatic diameter B b) Sub mento bregmatic diameter C c) mento vertical diameter D d) none of the above

Sub-Occipito bregmatic diameter (9.5 cm) is engaging diameter of

A a) vertices presentation when the head is completely flexed B b) face presentation when the head is completely extended C c) brow presentation D d) breech presentation

Definition of normal labor must fulfill the following except

A a) single fetus B b) presented by vertex C c) term D d) without intervention apart from ventose extraction

Complication of the third stage of labor include

A a) post-partum hemorrhage. B b) retention of placenta. C c) inversion of uterus. D d) all of the above

which of the following fetal lies is most unstable

A a) longitudinal B b) oblique. C c) transverse. D straight

what percentage of the fetal lies are longitudinal

A a) 50% B b) 75% C 84% D c) 99.5%

in longitudinal lies the presenting part can be the

A a) Head. B b) Breech C c) Shoulder. D d) A&B.

the portion of the fetus which Firstly meet the pelvic brim determiner

A a) fetal lie. B b) fetal position. C c) fetal presentation D d) none of the aboved

the main factor responsible for internal rotation of the head is the

A a) sloping character of the pelvic floor. B b) shape of the pelvis. C c) Ch unequal flexibility of different parts of the uterus. D d) function of the pelvis

fetal head delivery in Occipito-anterior occurs by movement of

A a) flexion B b) extension C c) rotation D d) none of the above

in left Occipito-anterior position, the shoulder enter the pelvis in the

A a) left oblique diameter. B b) right oblique diameter. C c) antero-posterior diameter D d) Transverse diameter.

the term (crowing) refers to the parregel biparietal diameter

A a) outside the vulval ring B b) below the level of ischial spine C c) below the pelvic brim D d) any of the above

the active management of the 3rd stage of labor ergometrine is given I.M or syntometrine I.M with

A a) crowing of the head. B b) delivery of the anterior shoulder. C c) A&B D d) frequent inspection if the perineum for bleeding.

to minimize perineal tears during the 2nd stage of labor

A a) do perineal support B b) episiotomy is done. C c) following ritgen maneuver D d) all of the above.

The third stage of normal labor starts with

A a) delivery of fetal head. B b) delivery of fetus. C c) delivery of placenta D d) clamping of umbilical cord.

the most important transvers diameter of the fetal head is

A a) Subparietal supraparietal diameter B b) Mento vertical diameter C c) bimastoid diameter D d) Biparietal diameter.

During which cardinal movement of labor Is the head returned to the oblique

A a) Restitution B b) Expulsion C c) External rotation D d) Extension.

Partogram

A a) Is used by the patient to record the uterine contractions B b) Is done before diagnosis of labor C c) Measures progression of labor. D d) Is of utmost importance in the latent phase

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