NM 704 EXAM 2 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++
What begins with onset of regular contractions?
Latent phase
What phase begins when rate of progress increases?
Active phase
When can protracted and arrested descent be diagnosed?
Only during second stage
What is the rate of descent per Friedman of nulliparas?
1 cm/hr
What is the rate of descent per Friedman of multiparas?
2cm/hr
What is the rate of dilation per Friedman of nulliparas in the active stage?
1.2 cm/hr
What is the rate of dilation per Friedman of multiparas in the active stage?
1.5 cm/hr
Per the Friedman criteria, what is progress that is occurring, but more slowly than
normal?
Protraction disorder
Per the Friedman criteria, what is progress that is no progress?
Arrest disorder
,Per Friedman, what is no dilation in 2 hours?
Arrest of dilation
Per Friedman, what is no descent in 1 hour?
Arrest of descent
Is there a difference in arrest disorders based on parity?
No
The goal of ________ is to facilitate the process of cervical softening, thinning,
and dilating with resultant reduction in the rate of failed induction and induction
to delivery time.
Cervical ripening
A Bishop score of _______ increases probability of vaginal delivery after labor
induction.
8
What are advantages of the foley catheter to prostaglandins for induction?
(1) low cost (2) stability at room temperature (3) reduced risk of uterine tachysystole
When is a steady state of oxytocin achieved in plasma?
40 minutes
According to ACOG, stripping membranes increases the change of labor starting
when?
Within 48 hours
When amniotomy is used alone for labor induction, what are the outcomes?
Unpredictable
, What are maternal or fetal conditions that may be indications for induction of
labor?
(1) abruptio placentae (2) chorioamnionitis (3) fetal demise (4) gestational htn (5)
preeclampsia/eclampsia (6) PPROM (7) postterm pregnancy (8) maternal medical
conditions (9) fetal compromise
What are some contraindication for labor induction?
(1) vasa previa or complete placenta previa (2) transverse fetal lie (3) umbilical cord
prolapse (4) previous classical cesarean delivery (5) active genital herpes infection (6)
previous myomectomy entering the endometrial cavity
Does misoprostol or dinoprostone have greater risk for uterine tachysystole?
Misoprostol
What is the risk of using misoprostol in women with prior cesarean?
Uterine rupture
What other increase is associated with use of misoprostol?
Meconium-stained amniotic fluid
When using PGE2, what patient populations should caution be exercised with?
(1) glaucoma (2) severe hepatic dysfunction (3) severe renal dysfunction
What are the potential risk with an amniotomy?
(1) prolapse of umbilical cord (2) chorioamnionitis (3) significant umbilical cord
compression (4) rupture of vasa previa
What are the risks of stripping amniotic membranes?
(1) undiagnosed placenta previa or low lying placenta (2) accidental amniotomy
COMPLETE SOLUTIONS GRADED A++
What begins with onset of regular contractions?
Latent phase
What phase begins when rate of progress increases?
Active phase
When can protracted and arrested descent be diagnosed?
Only during second stage
What is the rate of descent per Friedman of nulliparas?
1 cm/hr
What is the rate of descent per Friedman of multiparas?
2cm/hr
What is the rate of dilation per Friedman of nulliparas in the active stage?
1.2 cm/hr
What is the rate of dilation per Friedman of multiparas in the active stage?
1.5 cm/hr
Per the Friedman criteria, what is progress that is occurring, but more slowly than
normal?
Protraction disorder
Per the Friedman criteria, what is progress that is no progress?
Arrest disorder
,Per Friedman, what is no dilation in 2 hours?
Arrest of dilation
Per Friedman, what is no descent in 1 hour?
Arrest of descent
Is there a difference in arrest disorders based on parity?
No
The goal of ________ is to facilitate the process of cervical softening, thinning,
and dilating with resultant reduction in the rate of failed induction and induction
to delivery time.
Cervical ripening
A Bishop score of _______ increases probability of vaginal delivery after labor
induction.
8
What are advantages of the foley catheter to prostaglandins for induction?
(1) low cost (2) stability at room temperature (3) reduced risk of uterine tachysystole
When is a steady state of oxytocin achieved in plasma?
40 minutes
According to ACOG, stripping membranes increases the change of labor starting
when?
Within 48 hours
When amniotomy is used alone for labor induction, what are the outcomes?
Unpredictable
, What are maternal or fetal conditions that may be indications for induction of
labor?
(1) abruptio placentae (2) chorioamnionitis (3) fetal demise (4) gestational htn (5)
preeclampsia/eclampsia (6) PPROM (7) postterm pregnancy (8) maternal medical
conditions (9) fetal compromise
What are some contraindication for labor induction?
(1) vasa previa or complete placenta previa (2) transverse fetal lie (3) umbilical cord
prolapse (4) previous classical cesarean delivery (5) active genital herpes infection (6)
previous myomectomy entering the endometrial cavity
Does misoprostol or dinoprostone have greater risk for uterine tachysystole?
Misoprostol
What is the risk of using misoprostol in women with prior cesarean?
Uterine rupture
What other increase is associated with use of misoprostol?
Meconium-stained amniotic fluid
When using PGE2, what patient populations should caution be exercised with?
(1) glaucoma (2) severe hepatic dysfunction (3) severe renal dysfunction
What are the potential risk with an amniotomy?
(1) prolapse of umbilical cord (2) chorioamnionitis (3) significant umbilical cord
compression (4) rupture of vasa previa
What are the risks of stripping amniotic membranes?
(1) undiagnosed placenta previa or low lying placenta (2) accidental amniotomy
