The concept of physiological labor
!The premature delivery is called so when it occurs in the next weeks of pregnancy
* 12 to 15
* 16 to 21
* 37 to 40
* 41 to 42
* 22 to 37
!A sign of the onset of labor is the appearance of
* Blood show
* Mucus plug from the vagina
* irregular contractions
* regular contractions
* powerful muscular contractions
! The physiological process during which the expulsion of the fetus, placenta and membranes from the uterus through the birth canal occurs is called
* delivery
* powerful muscular contractions
* contractions
* false contractions
* amniorrhea
! False contractions are called so when they are
* Incoordinated
* irregular
* regular
* excessive
* powerful muscular contractions
! The totality of the translational and rotational motions made by the fetus during the passage through the true pelvis and soft parts of the birth canal is called
* configuration of head
* biomechanism of delivery
* flexion of head
* contractions
* powerful muscular contractions
!The reduction of the muscle fibers of the uterus is called
* dystocia
* retraction
* distraction
* contraction
* discoordination
!The displacement of muscle fibers of the uterus and change of their relative position is called
* dystocia
* retraction
* distraction
* contraction
* discoordination
! The reduction of the muscle fibers of the corpus uteri, pulling the circular muscles of the cervix to the side and up is called
* dystocia
* retraction
* contraction
* distraction
* discoordination
! During contractions in the muscles of the corpus uteri the following changes take place:
* Polarization, depolarization
* Areflexion, atony, hypotension
* Contraction, retraction, distraction
* Muscle relaxation, discoordination, dystocia
* Compensation, subcompensation, decompensation
! The contraction of myometrium is
* regrouping of muscles
* stretching of muscle fibers
* contraction of the muscle fibers
* stretching of circular muscle of cervix
* relative displacement of the fibers
! The retraction of myometrium is
* regrouping of muscles
* tension of the muscle fibers
* contraction of muscle fibers
* stretching of circular muscle of cervix
* relative displacement of the fibers
! The distraction of myometrium is
* regrouping of muscles
* contraction of the muscle fibers
* stretching of muscle fibers
* stretching of circular muscle of cervix
* relative displacement of the fibers
! Uterine contractions begin in the fundus of the uterus and take all the muscles of corpus of the uterus until
* vagina
* cervix uteri
* perineum
* lower segment of the uterus
* vulvar ring
! The dominant focus of excitation contraction in the uterus is often localized at the
* fundus of the uterus
* left corner of the uterus
* cervix uteri
* right corner of the uterus
* lower segment of the uterus
! The structural changes of the cervix during delivery of nulliparous start from the area of
* external os of the cervical canal
* internal os of the cervical canal
* cervical canal
* vaginal part of the cervix
* Internal and external oses in parallel
! By the Bishop's score the following states of the cervix can be
* Firm, soft, rigid
* Long, Medium, Short,
* Central, Eccentric
* Immature, maturing, mature
* Compensated, subcompensated, decompensated
! The dilation, effacement, consistency and position of the cervix relatively to the wire axis of the pelvis and the position of the fetus' head in relation to the distance from the ischial spines are the criteria of the
* Apgar score
* Bishop's score
* index of Solovyov
* Silverman score
* formula of Jordania
!Cervix is assessed as «immature» if Bishop's score is
* 1-2
* less than 4
* less than 6
* 6-8
* 9 and more
!Cervix is assessed as «maturing» if Bishop’s score is
* 1-2
* less than 4
* less than 6
* 6-8
* 9 and more
! Cervix is assessed as «mature» if Bishop’s score is
* 1-2
* less than 4
* less than 6
* 6-8
* 9 and more
! If in a full-term pregnancy a pregnant woman’s cervix is 1-2 cm long, soft, occupies the wire axis of pelvis, the cervical canal disclosed to 3 cm, the head is at the level of the ischial spines, then the cervix is assessed by the Bishop's score as
* mature
* immature
* maturing
* latent phase of labor
* active phase of labor
! If in a full-term pregnancy a pregnant woman’s cervix is 3 cm long, is partially softened, occupies the middle position relatively to the wire axis of pelvis, the cervical canal disclosed to 2-3 cm, the head is 2 cm above the level of the ischial spines, the cervix is assessed by the Bishop's score as
* mature
* immature
* maturing
* latent phase of labor
* active phase of labor
! If in a full-term pregnancy a pregnant woman’s cervix is 3-4 cm long, firm, turned backwards relatively to the wire axis of pelvis, the cervical canal is closed, the head is 2 cm above the level of the ischial spines, the cervix is assessed by the Bishop's score as
* mature
* immature
* maturing
* latent phase of labor
* active phase of labor
The stages of labor
! During first stage of labor vaginal examinations are performed at interval:
* 30 minutes
* 2 hours
* 4 hours
* 6 hours
* 8 hours
! Labor act consists of the following number of periods
* 1
* 2
* 3
* 4
* 5
! The average duration of the 1st stage of labor of nulliparous is (hours)
* 1-3
* 4-5
* 6-7
* 8-9
* 10-11
! The average duration of the 1st stage of labor of multiparous is (hours)
* 1-3
* 4-5
* 7-9
* 8-9
* 10-11
! The objective criterion of efficiency of labor in first stage of labor is
* intensity of uterine contraction
* intensity of expulsive efforts
* Color of amniotic fluid
* Amount of amniotic fluid
* Dynamics of cervical dilatation
! The dilatation rate in the latent phase of first stage of labor should be not slower than (cm / hour)
* 0.15
* 0.35
* 0.5
* 1.0
* 1.5
! The dilatation rate in the active phase of first stage of labor should be not slower than (cm / hour)
* 0.15
* 0.35
* 0.5
* 1.0
* 1.5
! The average duration of the second stage of labor in nulliparous is
* 15-25 minutes
* 30-55 minutes
* 1-2 hours
* 3-4 hours
* 5-6 hours
! This picture shows the following fetal presentation, position and variety of position
* left occiput anterior
* left occiput posterior
* right face anterior
* right occiput anterior
* right occiput posterior
! This picture shows the following fetal presentation and variety of position
* Face, anterior
* Occipital, posterior
* Occipital, anterior
* brow, posterior
* brow, anterior
! This picture shows the following fetal presentation, position and variety of position
* left occiput posterior
* left occiput anterior
* right face anterior
* right occiput anterior
* right occiput posterior
! This picture shows the following fetal presentation and variety of position
* Face, anterior
* Occipital, posterior
* Occipital, anterior
* brow, posterior
* brow, anterior
! In this picture the fetal head is located in the plane of the
* pelvic inlet (small segment of fetal head in pelvic inlet)
* pelvic inlet (large segment of fetal head in pelvic inlet)
* greatest pelvic dimensions
* least pelvic dimensions (midpelvis)
* pelvic outlet
! Active management of the third stage of labor involves the use of
* Methylergometrinum
* Misoprostol
* Oxytocin
* Enzaprost (dinoprost)
* Pabal (carbetocin)
! According to the clinical protocols (2013) active management of the third stage of labor involves intramuscular injection of 10 IU of oxytocin after
* Separation of placenta
* delivery of shoulders
* disengagement
* Engagement of the fetal head
* delivery of the anterior shoulder
! During the first hour after delivery the tone of the uterus is assessed every
* 5 minutes
* 10 minutes
* 15 minutes
* 20 minutes
* 30 minutes
! The physiological blood loss during delivery of the body weight (%)
* 0.5
* 10
* 15
* 20
* 2.5
! The physiological blood loss during delivery after normal pregnancy must not exceed relatively to body weight
* 1%
* 2%
* 0.3%
* 0.5%
* 0.8%
! The physiological blood loss of pregnant women suffering from anemia relatively to body weight is (%)
* 0.1
* 0.2
* 0.3
* 0.4
* 0.5
Partograph
! What is shown in this fragment of partograph
* mother’s pulse
* Fetal heartbeat
* arterial pressure
* Amount of amniotic fluid
* intensity of uterine contraction
! What does symbol "X" show on this fragment of partograph
* configuration of fetal head
* cervical dilatation
* descent of fetal head
* intensity of uterine contraction
* time of discharge of amniotic fluid
! On this fragment of partograph cervical dilatation is (cm)
* 3
* 4
* 5
* 6
* 7
! On this fragment of partograph cervical dilatation is (cm)
* 1
* 2
* 3
* 4
* 5
! On this fragment of partograph cervical dilatation is (cm)
* 1
* 2
* 3
* 4
* 5
! At this fragment of partograph symbol "X" shows cervical dilatation of 3 cm, which corresponds to the next phase of labor
* False labor
* latent
* active
* third
* labors
! At this fragment of partograph symbol "X" shows cervical dilatation 4 cm, which corresponds to the next phase of the genera
* false labor
* latent
* active
* third
* labors
! At this fragment of partograph symbol "0" represents the next descent of the fetal head in the pelvic cavity
* 5/5
* 4/5
* 3/5
* 2/5
* 1/5
! At this fragment of partograph symbol "0" represents the next descent of the fetal head in the pelvic cavity
* 5/5
* 4/5
* 3/5
* 2/5
* 1/5
! On this fragment of partogram the descent of the fetal head in the pelvic cavity is 2/5. Clinically, this means that the fetal head under palpation
* 2 fingers above the symphysis pubis
* 5 fingers above the symphysis pubis
* 4 fingers above the symphysis pubis
* 3 fingers above the symphysis pubis
* 1 finger above the symphysis pubis
! In this fragment of partograph symbol "M" represents the following description of amniotic fluid
* intact
* clear
* absent
* blood
* meconium
! In this fragment of partograph symbol «I» shows the following characteristics of amniotic fluid
* intact
* clear
* absent
* blood
* meconium
! In this fragment "solid hatch" corresponds to the strong contractions, the duration of which is (seconds)
* Less than 10
* Less than 20
* 20-30
* 30-40
* 40 and more