Physiology of Labor: Comprehensive Questions & Answers

I. Knowledge Level Questions:

1. Choose the CORRECT statement regarding uterine contractions during labor:

C. They typically originate from a uterine corner and spread throughout the uterus.

2. Regarding pain symptoms of uterine contractions during labor, choose the INCORRECT statement:

E. Pain can be reduced with aspirin.

3. The following statements regarding the characteristics of labor contractions are all true, EXCEPT:

D. They lead to the complete formation of the lower uterine segment.

4. During labor, the physiological constriction ring of the uterus is located:

D. At the boundary between the upper and lower uterine segments.

5. What is the average duration of the placental stage in a nulliparous woman?

A. 10 minutes.

6. Choose the correct statement regarding Stage I of labor (cervical effacement and dilation):

A. From the beginning of cervical effacement until complete dilation.

7. Which of the following symptoms is most valuable in determining true labor:

E. Pink mucus discharge.

8. Prostaglandins are used to terminate pregnancy at what gestational age:

D. 36-42 weeks.

9. Cervical ripening occurs several days before labor and includes the following characteristics, EXCEPT:

D. Posteriorly tilted cervix.

10. Which stage of labor is the longest?

A. Latent phase.

11. When a fetus experiences fetal hypoxia, there is a redistribution of blood flow to certain organs, increasing the blood supply to the following EXCEPT:

A. Placenta.

12. During normal labor, the fetal heart rate is:

E. 120-190 beats per minute.

13. During active labor, the uterine activity has an intensity of:

A. Below 20 UM.

14. The total intensity of each uterine contraction during labor is:

E. 130-150 mmHg.

15. During labor, several maternal metabolic changes can affect the fetus. Choose the CORRECT statement:

B. Respiratory efforts, increased pulmonary ventilation, lead to respiratory alkalosis, which exacerbates metabolic acidosis.

16. Which statement is INCORRECT regarding Stage I of labor:

D. The active phase is when the cervix dilates rapidly.

17. Choose the correct statement regarding Stage II of labor:

C. This stage is completed by the efforts of the mother pushing.

18. Choose the INCORRECT statement regarding Stage III of labor:

C. The placental delivery time in a nulliparous woman is shorter than in a multiparous woman.

19. Choose the CORRECT statement regarding uterine contractions during labor:

C. Contractions increase in intensity and frequency.

20. Choose the INCORRECT statement regarding uterine contractions during labor:

B. Contractions occur in a cyclical pattern.

21. Choose the INCORRECT statement regarding the characteristics of uterine contractions during labor:

D. Contractions aid in the formation of the lower uterine segment.

22. The efficiency of a uterine contraction is:

D. The contraction intensity minus the baseline tone of the uterine muscle.

23. Monitoring uterine contractions during labor for at least 10 minutes is to:

C. Assess whether the regularity of contractions is appropriate for the stage of labor.

24. Which of the following effects is NOT caused by uterine contractions during labor on the mother’s body:

C. Formation of the amniotic sac.

25. Choose an effect that is NOT caused by uterine contractions on the mother’s pelvic soft tissues:

C. The bladder neck is pulled high above the pubic symphysis.

26. Which of the following phenomena is NOT caused by the effect of uterine contractions during labor on the fetus:

E. The formation of a serous bulge.

27. Which of the following changes does NOT occur during labor:

E. The urethra becomes shorter, causing the urinary meatus to be pulled down.

28. A pregnant woman in the last trimester experiencing intermittent lower abdominal pain may have the following conditions, EXCEPT:

C. Intestinal twisting, intestinal obstruction.

29. The rate of cervical effacement and dilation during labor depends on the following factors, EXCEPT:

B. How much the amniotic sac presses on the cervix.

30. According to the National Standards of Vietnam, the minimum gestational age for a preterm labor is:

A. 20 weeks.

31. In the first stage of labor, the average number of uterine contractions in 10 minutes is:

D. 4 contractions.

32. The number of uterine contractions in 10 minutes during the pushing stage is usually:

D. 5 contractions.

33. When the cervix is dilated to 2 cm, and after monitoring for 10 minutes, which of the following contraction frequencies would be considered strong?

C. 3 contractions.

34. Full-term labor is labor that occurs at a gestational age of:

B. 28-36 weeks.

35. Premature labor is labor that occurs at a gestational age of:

C. 37-41 weeks.

36. The average duration of labor in a nulliparous woman is:

C. 16-24 hours.

37. Which of the following signs is NOT a sign of normal labor:

C. Bright red bleeding.

38. Mucus discharge from the vagina during labor is due to:

C. Effacement and dilation of the cervix, causing the mucus plug to be expelled.

39. The lower uterine segment when fully formed has a length of:

D. 14 cm.

40. Uterine contractions are initiated by:

B. The spinal nerves.

41. The following statements regarding the anatomy of the lower uterine segment are all true, EXCEPT:

D. Thin mucosal layer.

42. Cervical effacement and dilation DO NOT depend on which factor:

C. Condition of the cervix.

43. Choose the INCORRECT statement regarding the conditions necessary for the formation of a serous bulge:

B. Engagement of the presenting part.

44. All the following statements regarding the advantages of cesarean section via the lower segment compared to cesarean section via the uterine body are true, EXCEPT:

Gulugulu (This phrase is nonsensical and doesn’t make sense in this context. Please provide additional context if you’d like assistance with this.)

45. Labor consists of 3 stages:

E. (Cervical effacement and dilation), Fetal delivery, (Placental delivery).

46. Choose the most logical statement regarding the average duration of a labor for a nulliparous woman:

D. Stage 1: 4 hours – Stage 2: 20 minutes – Stage 3: 20 minutes.

47. The pressure inside the uterus during a labor contraction is approximately:

C. 10-20 mmHg.

48. In a multiparous woman, what duration of placental delivery is considered physiological?

D. 60 minutes.

49. Choose the most accurate statement regarding the maximum permissible duration of Stage III (placental separation and delivery).

E. Placental delivery occurs due to uterine contractions and abdominal muscle contractions.

50. Which of the following factors does NOT influence the regulation of prostaglandin synthesis?

E. Catecholamines.

51. Uterine contractions during labor have the following effects, EXCEPT:

A. Propel the fetus towards the lower uterine segment.

52. During labor, which of the following factors has the most direct influence on the fetus?

A. Uterine contractions.

53. Decreased uterine-placental blood flow is commonly encountered in the following situations, EXCEPT:

E. Use of sedatives.

54. Which of the following factors plays the most fundamental role in closing the ductus arteriosus?

A. Closure of the umbilical arteries.

55. During labor, the baseline tone of the uterus changes to:

E. >35 mmHg.

56. Which hormone does NOT influence the regulation of uterine contractions during labor?

D. Prostaglandin.

57. When does the formation of the lower uterine segment occur during pregnancy?

C. Eighth month.

58. During labor, which of the following factors does NOT cause hemodynamic disturbances?

C. Left lateral recumbent position.

59. Of the following statements, which is INCORRECT?

D. Oxygen deficiency during labor increases PGF2? synthesis.

60. Choose the most accurate statement regarding the cause of labor:

D. Prostaglandins play a fundamental role in a cascade of mechanisms that trigger labor.

61. Choose the INCORRECT statement regarding the nature of pain caused by uterine contractions during labor:

A. Pain intensity varies among women.

62. Which statement is INCORRECT regarding cervical effacement and dilation and the formation of the lower uterine segment?

B. Cervical effacement and dilation differ between nulliparous and multiparous women.

63. Which of the following phenomena is NOT caused by the effect of uterine contractions during labor on fetal adnexa?

A. Formation of the amniotic sac.

64. During labor, the consequences of decreased uterine contractions are:

C. Postpartum hemorrhage.

65. Which statement is NOT included in the signs for diagnosing labor?

B. Pink mucus discharge from the vagina.

66. If the cervix is dilated to 3 cm, and after monitoring for 10 minutes, which of the following timeframes would be considered prolonged Stage Ia and require intervention?

E. 12 hours.

67. Choose the most accurate phrase to complete the following definition of labor: labor is a process that involves:

E. Cervical effacement and dilation, fetal delivery, and placental delivery through the vaginal canal.

68. The following statements regarding the nature of uterine contractions during labor are all true, EXCEPT: During labor, uterine contractions gradually increase in:

C. Baseline tone.

69. Fetal monitoring (CTG) allows for the monitoring of:

C. Uterine contractions, fetal heart rate, and the effect of uterine contractions on the fetal heart rate.

70. The amniotic sac forms when:

C. Uterine contractions cause separation of the amniotic membrane at the lower pole.

71. During labor, a vaginal examination reveals a contraction frequency of 4, cervical dilation of 9-10 cm, the woman is experiencing significant abdominal pain, and she feels the urge to push. The woman is in which stage of labor?

B. Stage Ib.

72. The following statements regarding the characteristics of uterine contractions during labor are all true, EXCEPT:

B. Intensity is uniform throughout the uterus.

73. The Monte Video Unit is:

E. The number of uterine contractions in 10 minutes multiplied by the intensity of the contraction.

74. When monitoring labor, it is necessary to measure at least 3 consecutive contractions to:

C. Assess average contraction intensity, as each contraction can differ in duration and rest time.

75. All of the following statements regarding the cause of pain during labor contractions are true, EXCEPT:

D. Pain occurs when the cervix dilates significantly during a contraction.

76. Prostaglandin production during pregnancy reaches its highest rate at:

A. During the first trimester.

77. At the peak of a uterine contraction, the placental-fetal circulation is interrupted for approximately:

E. 4 minutes.

78. Normal labor depends on the following factors, choose the correct answer:

E. Depends on the mother, uterine contractions, fetus, and placenta.

79. When there is fetal hypoxia, the following conditions are observed, choose the INCORRECT statement:

D. Redistribution of blood flow to individual regions.

80. Closure of the foramen ovale in a newborn is attributed to the following factors, EXCEPT:

D. Decreased blood flow from the veins to the left atrium.

81. Closure of the ductus arteriosus in a newborn is attributed to the following factors, EXCEPT:

A. Disruption of placental-fetal circulation.

82. During labor, when uterine contractions occur, blood flow in the uterine artery decreases by approximately:

A. 30%.

83. During placental delivery, the frequency and intensity of uterine contractions increase, and the uterine artery and venous lake circulation are interrupted, leading to:

A. Lowered PO2 and increased PCO2.

84. In a nulliparous woman, during the active phase of labor, the cervix dilates an average of:

B. 2 cm/hour.

85. Of the following statements, choose the INCORRECT one:

E. 1 mmHg = 0.133 kPa.

86. Of the following statements, which is CORRECT?

E. Uterine artery flow decreases by 30% during uterine contractions, and there is a decrease in fetal oxygenation with normal uterine contractions.

87. Which of the following is NOT observed in a fetus experiencing hypoxia?

C. Dilation of brain and coronary arteries.

88. How does the fetal heart rate normally change due to the influence of uterine contractions?

A. The fetal heart rate increases at the beginning of a contraction and then returns to normal until the contraction ends.

89. Which of the following types of amniotic sac is NOT encountered during labor?

D. Pear-shaped amniotic sac.

90. During normal labor, the fetus undergoes the following changes, choose the INCORRECT statement:

C. The fetus is pushed from the uterus to the outside.

91. Uterine contractions during labor cause pain for the woman when the pressure reaches:

C. 25-30 mmHg.

II. Analysis and Application Level Questions:

92. The Monte Video Unit is:

B. The number of uterine contractions in 1 minute multiplied by the intensity of the contraction.

93. When monitoring labor, it is necessary to measure at least 3 consecutive contractions to:

C. Assess average contraction intensity, as each contraction can differ in duration and rest time.

94. All of the following statements regarding the cause of pain during labor contractions are true, EXCEPT:

D. Pain occurs when the cervix dilates significantly during a contraction.

95. Prostaglandin production during pregnancy reaches its highest rate at:

A. During the first trimester.

96. At the peak of a uterine contraction, the placental-fetal circulation is interrupted for approximately:

E. 4 minutes.

97. Normal labor depends on the following factors, choose the correct answer:

E. Depends on the mother, uterine contractions, fetus, and placenta.

98. When there is fetal hypoxia, the following conditions are observed, choose the INCORRECT statement:

D. Redistribution of blood flow to individual regions.

99. Closure of the foramen ovale in a newborn is attributed to the following factors, EXCEPT:

D. Decreased blood flow from the veins to the left atrium.

100. Closure of the ductus arteriosus in a newborn is attributed to the following factors, EXCEPT:

A. Disruption of placental-fetal circulation.

101. During labor, when uterine contractions occur, blood flow in the uterine artery decreases by approximately:

A. 30%.

102. During placental delivery, the frequency and intensity of uterine contractions increase, and the uterine artery and venous lake circulation are interrupted, leading to:

A. Lowered PO2 and increased PCO2.

103. In a nulliparous woman, during the active phase of labor, the cervix dilates an average of:

B. 2 cm/hour.

104. Of the following statements, choose the INCORRECT one:

E. 1 mmHg = 0.133 kPa.

105. Of the following statements, which is CORRECT?

E. Uterine artery flow decreases by 30% during uterine contractions, and there is a decrease in fetal oxygenation with normal uterine contractions.

106. Which of the following is NOT observed in a fetus experiencing hypoxia?

C. Dilation of brain and coronary arteries.

107. How does the fetal heart rate normally change due to the influence of uterine contractions?

A. The fetal heart rate increases at the beginning of a contraction and then returns to normal until the contraction ends.

108. Which of the following types of amniotic sac is NOT encountered during labor?

D. Pear-shaped amniotic sac.

109. During normal labor, the fetus undergoes the following changes, choose the INCORRECT statement:

C. The fetus is pushed from the uterus to the outside.

110. Uterine contractions during labor cause pain for the woman when the pressure reaches:

C. 25-30 mmHg.

Note: This is just a sample of questions and answers related to the physiology of labor. For a comprehensive understanding, please refer to specialized medical textbooks and clinical practice.