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Book 2: Maternal and Fetal Care
UNIT 11: ABNORMAL LABOR PROGRESS AND DIFRCULT DELIVERIES

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Shoulder dystocia occurs more commonly in all of the following conditions, except
You see the sudden onset of severe variable decelerations on a fetal heart rate tracing. Of the following actions , what is the first thing you should do?
With meconium-stained amniotic fluid, the baby's mouth and nose should be suctioned after delivery of the head, but before delivery of the shoulders.
Narcotics given to a laboring woman may cause minimal or absent fetal heart rate variability.
Face presentation puts a baby at risk for spinal cord injury.
The fetal head should be engaged before a forceps delivery is attempted.
Once normal fetal size, presentation, and position and adequate pelvic size have been determined, oxytocin augmentation is the treatment of choice for hypertonic uterine dysfunction.
When cord prolapse occurs, one appropriate way to elevate the presenting part off of the cord is to fill the woman's bladder with 500 ml of sterile saline and have her assume the knee-chest position.
Contraction quality is poor, but baseline tonus is usually increased with hypotonic uterine dysfunction
Which of the following conditions should always be present before forceps or vacuum extraction delivery is attempted?
   
Yes No
 
 
 
 
 
In which of the following situations is oxytocin augmentation of labor likely to be useful (assuming normal fetal size, presentation, and position and normal pelvic size are present)?
   
Yes No
 
 
 
 
Maternal risks of rapid labor include all of the following complications, except
Which of the following interventions are appropriate when rapid cervical dilation is occurring and rapid delivery is anticipated?
   
Yes No
 
 
 
 
 
 
 
Which of the following are associated with vaginal breech delivery?
   
Yes No
 
 
 
 
If there is excessive bleeding during the third stage of labor, oxytocin should be administered to cause the uterus to contract and expel the placenta .
The second stage of labor normally lasts 6 hours or longer.
Oxytocin infusion may be appropriate treatment for second­ stage arrest of labor.
If delivery of the placenta does not occur within 30 minutes of delivery of the baby, but there is no evidence of vaginal bleed­ing, it is best to wait for spontaneous delivery of the placenta.
Ultrasonographic estimation of fetal weight is less accurate when the fetal head is deep in the woman's pelvis.
The hallmark of active labor is contractions with progressive cervical dilation.
Goiter and tumors of the fetal neck are associated with an increased likelihood of a fetus being in face or brow presentation
The most common cause of prolonged labor is breech presenattion .
A woman is exhausted and can no longer push effectively. The fetus is vertex, right occiput posterior, at +3 station. Manual rotation of the head and low forceps delivery is one appropriate approach to this situation.
Artificially rupturing the membranes to stimulate labor in a woman with a prolonged latent phase will require a cesarean delivery if labor does not progress.
When fetal gestational age is 34 weeks or less and an operative vaginal delivery is indicated, a vacuum extractor is preferred to forceps.
Which of the following conditions is most likely to be a cause of a prolonged latent phase?
Which of the following conditions is the best indication of active labor?
Once labor becomes established, clues to abnormal progress include all of the following situations, except
Evaluation of a prolonged active phase reveals fetal hydrocephalus. The fetus is vertex, with a reassuring fetal heart rate pattern. Which of the following actions are appropriate to take?
   
Yes No