373. Choose the CORRECT statement about uterine contractions during labor:

• A. They are called Braxton-Hicks contractions.
• B. Their frequency remains constant throughout labor.
• C. They usually originate from one uterine horn and then spread throughout the uterus.
• D. The average pressure inside the uterus during a contraction is about 8-10mmHg.

Answer: C

Note: Braxton-Hicks contractions are false labor contractions that occur before labor. The frequency of contractions changes during different stages of labor. The average pressure inside the uterus during a contraction is much higher than 8-10mmHg.

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

• A. The internal os of the cervix.
• B. The external os of the cervix.
• C. The site of attachment of the round ligament to the uterus.
• D. The boundary between the upper and lower uterine segments.

Answer: D

375. Choose the correct statement about Stage I of labor (the stage of cervical effacement and dilation):

• A. From the time cervical effacement begins until it is fully dilated.
• B. From the time cervical effacement begins until it reaches 3 cm dilation.
• C. From the time the cervix is fully effaced until it reaches 3 cm dilation.
• D. From the time the cervix reaches 3 cm dilation until it is fully dilated.

Answer: A

Note: Stage I of labor encompasses both cervical effacement and dilation.

376. Which of the following symptoms is diagnostic of labor:

• A. Uterine contractions with a frequency of 3.
• B. Changes in fetal heart rate.
• C. Formation of the forewater.
• D. Passage of the mucous plug.

Answer: A

Note: Regular uterine contractions with a decreasing interval between them are a hallmark of labor. Other symptoms like changes in fetal heart rate, formation of the forewater, and passage of the mucous plug can occur before labor or during labor.

377. During normal labor, the baseline fetal heart rate is:

• A. 120-160 beats per minute.
• B. 120-170 beats per minute.
• C. 100-160 beats per minute.
• D. 120-180 beats per minute.

Answer: A

Note: Baseline fetal heart rate can fluctuate slightly. Changes in fetal heart rate during labor require careful monitoring to assess the fetal condition.

378. The strength of a uterine contraction is:

• A. The contraction at its highest intensity.
• B. The highest intensity of the contraction minus the lowest intensity.
• C. The average of the highest and lowest intensities.
• D. The contraction intensity minus the baseline tone of the uterine muscle.

Answer: D

Note: The strength of a uterine contraction reflects the intensity of uterine muscle contraction, helping to expel the fetus.

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

• A. Determine the duration of each contraction.
• B. Determine the interval between contractions.
• C. Assess the regularity of contractions and their suitability for the stage of labor.
• D. All of the above.

Answer: D

Note: Monitoring uterine contractions helps evaluate labor progress and detect early abnormalities.

380. According to Vietnamese National Standards, the minimum gestational age of a preterm labor is:

• A. 22 weeks.
• B. 28 weeks.
• C. 30 weeks.
• D. 36 weeks.

Answer: A

Note: The minimum gestational age for a fetus to have a chance of survival is 22 weeks.

381. During the pushing stage of labor, the number of uterine contractions in 10 minutes is usually:

• A. 3 contractions.
• B. 4 contractions.
• C. 5 contractions.
• D. 6 contractions.

Answer: C

Note: The number of uterine contractions can vary depending on the individual.

382. When the cervix is dilated 2 cm, and after monitoring for 10 minutes, which of the following contraction frequencies is considered strong:

• A. 2 contractions.
• B. 3 contractions.
• C. 4 contractions.
• D. 5 contractions.

Answer: C

Note: Strong labor is assessed based on the frequency, intensity, and duration of uterine contractions.

383. Term labor is labor that occurs at a gestational age of:

• A. 22-28 weeks.
• B. 28-36 weeks.
• C. 38-42 weeks.
• D. > 42 weeks.

Answer: C

Note: Term labor usually occurs between 38 and 42 weeks of gestation.

384. Preterm labor is labor that occurs at a gestational age of:

• A. 20-22 weeks.
• B. 22-37 weeks.
• C. 37-41 weeks.
• D. > 42 weeks.

Answer: B

Note: Preterm labor can lead to various complications for both the mother and the baby.

385. The average duration of labor in a primipara is:

• A. 8-12 hours.
• B. 12-16 hours.
• C. 16-24 hours.
• D. 24-26 hours.

Answer: C

Note: Labor duration can vary depending on individual circumstances.

386. The passage of the mucous plug during labor is due to:

• A. Secretion of cervical mucus.
• B. Formation of the lower uterine segment.
• C. Cervical effacement and dilation, with expulsion of the cervical mucous plug.
• D. Amniotic fluid leakage mixed with vaginal secretions.

Answer: C

Note: The cervical mucous plug is a thick layer of mucus that protects the cervix during pregnancy. During labor, this plug is expelled, often accompanied by a small amount of blood.

387. All the following statements about the advantages of a lower segment cesarean section compared to a classical cesarean section are true EXCEPT:

• A. The peritoneum is easily dissected and can cover the incision.
• B. It is easier to deliver the baby.
• C. It causes less bleeding.
• D. The scar is softer.

Answer: B

Note: A lower segment cesarean section generally allows for easier delivery compared to a classical cesarean section.

388. Labor consists of 3 stages:

• A. (Cervical effacement and dilation)
• B. Delivery of the baby.
• C. (Delivery of the placenta)

Answer: Stage 1: Cervical effacement and dilation, Stage 2: Delivery of the baby, Stage 3: Delivery of the placenta.

Note: The 3 stages of labor play crucial roles in the birthing process.

389. Choose the most reasonable statement about the average duration of a vaginal delivery:

• A. Stage 1: 12 hours – Stage 2: 80 minutes – Stage 3: 30 minutes.
• B. Stage 1: 6 hours – Stage 2: 80 minutes – Stage 3: 5 minutes.
• C. Stage 1: 4 hours – Stage 2: 20 minutes – Stage 3: 20 minutes.
• D. Stage 1: 12 hours – Stage 2: 40 minutes – Stage 3: 10 minutes.

Answer: D

Note: Labor duration can vary greatly depending on the individual.

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

• A. 20-40mmHg.
• B. 10-20mmHg.
• C. 50-80mmHg.
• D. 100-120mmHg.

Answer: C

Note: Intrauterine pressure during contractions is higher than baseline pressure, helping to push the fetus out.

391. In a multipara, how long is the average time for placental delivery to be considered physiological?

• A. 15 minutes.
• B. 45 minutes.
• C. 30 minutes.
• D. 60 minutes.

Answer: C

Note: Placental delivery time can vary depending on the individual.

392. Choose the most accurate statement about the maximum permissible time for Stage III (the stage of placental separation and delivery).

• A. Placental delivery should take 15 to 30 minutes.
• B. Placental delivery should take 1 hour.
• C. Placental delivery can be awaited until it detaches without intervention if there is no bleeding.
• D. Placental delivery from delivery of the baby to placental delivery should take a maximum of 1 hour.

Answer: D

Note: Placental delivery needs close monitoring to detect and manage any abnormalities promptly.

393. During labor, which of the following factors most directly affects the fetus:

• A. Uterine contractions.
• B. Intact membranes.
• C. Rupture of membranes.
• D. Maternal position.

Answer: A

Note: Uterine contractions exert pressure on the fetus, affecting fetal blood flow and heart rate.

394. Reduced uteroplacental blood flow is commonly seen in the following situations EXCEPT:

• A. Supine position.
• B. Epidural anesthesia.
• C. Uterine contractions.
• D. Use of sedatives.

?

Note: This question needs to be reconsidered because all the options can potentially lead to reduced uteroplacental blood flow.

395. Which of the following plays the most fundamental role in closing the ductus venosus:

• A. Closure of the ductus arteriosus.
• B. Closure of the foramen ovale.
• C. Pulmonary ventilation.
• D. Clamping of the umbilical cord.

Answer: D

Note: The ductus venosus is part of the umbilical cord and closes when umbilical cord circulation is clamped.

396. During labor, the baseline tone of the uterus is:

• A. 12-13 mmHg.
• B. 20-25 mmHg.
• C. 25-30 mmHg.
• D. 30-35 mmHg.

Answer: A

Note: Baseline uterine tone refers to the tension in the uterine muscle when there are no contractions.

397. The formation of the lower uterine segment during pregnancy occurs at what point:

• A. The 7th month.
• B. The 8th month.
• C. Late in the gestational period of a primipara, starting with labor in a multipara.
• D. During the stage of cervical effacement and dilation.

Answer: C

Note: The lower uterine segment forms gradually during pregnancy and is complete by the onset of labor.

398. Choose the most accurate statement about the causes of labor:

• A. Labor occurs due to excessive stretching of the uterine muscle.
• B. The primary cause of labor is a sudden decrease in the hormones estrogen and progesterone.
• C. Prostaglandins play the primary role in causing labor.
• D. Prostaglandins play a fundamental role in a chain of mechanisms that trigger labor.

Answer: D

Note: Labor is a complex process involving numerous factors, with prostaglandins playing a key role.

399. Which of the following statements is FALSE about cervical effacement and dilation and the formation of the lower uterine segment:

• A. The timing of lower uterine segment formation is the same in primiparas and multiparas.
• B. Cervical effacement and dilation differ between primiparas and multiparas.
• C. In primiparas, the cervix effaces completely before it dilates.
• D. In multiparas, the cervix effaces and dilates simultaneously.

Answer: A

Note: The lower uterine segment typically forms earlier in multiparas than in primiparas.

400. During labor, the consequences of a decrease in uterine contractions are:

• A. Slow cervical effacement and dilation.
• B. Premature rupture of membranes.
• C. Postpartum hemorrhage.
• D. Fetal distress.

Answer: A

Note: Decreased uterine contractions can prolong labor, making it difficult to push the fetus out.

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

• A. Uterine contractions and maternal condition during labor.
• B. Fetal heart rate and maternal condition during labor.
• C. Uterine contractions, fetal heart rate, and the effect of uterine contractions on fetal heart rate.
• D. Uterine contractions and fetal heart rate.

Answer: C

Note: CTG is an essential tool for monitoring the fetal condition during labor.

402. The Montevideo unit is:

• A. The number of uterine contractions in 10 minutes.
• B. The number of uterine contractions in 1 minute multiplied by the contraction intensity.
• C. The contraction intensity multiplied by the time it takes to have 10 contractions.
• D. The number of uterine contractions in 10 minutes multiplied by the contraction intensity.

Answer: D

Note: The Montevideo unit is used to assess the strength of uterine contractions.

403. Prostaglandin production during pregnancy reaches its highest level at what point:

• A. During the first trimester.
• B. During the second trimester.
• C. During the third trimester.
• D. The onset of labor.

Answer: D

Note: Prostaglandins play a crucial role in the labor process.

404. At the peak of a uterine contraction, uteroplacental circulation is interrupted for approximately:

• A. 15-60 seconds.
• B. 10 seconds.
• C. 2 minutes.
• D. 3 minutes.

Answer: A

Note: This interruption of uteroplacental circulation during a contraction is a physiological event.

405. Normal labor depends on which of the following factors, choose the correct answer:

• A. Depends on the mother.
• B. Depends on the fetus.
• C. Depends on the placenta.
• D. Depends on the umbilical cord.
• E. Depends on the mother, uterine contractions, the fetus, and the fetal adnexa.

Answer: E

Note: Labor is a complex process involving multiple factors.

406. During labor, uterine contractions reduce blood flow in the uterine artery by approximately:

• A. 30%.
• B. 40%.
• C. 50%.
• D. 60%.

Answer: A

Note: This reduction in uterine artery blood flow during contractions is a physiological response.

407. In primiparas, during the active phase of labor, the cervix dilates an average of:

• A. 1cm/1h.
• B. 2cm/1h.
• C. 3cm/1h.
• D. 4cm/1h.

Answer: A

Note: The rate of cervical dilation can vary depending on the individual.

408. Which of the following statements is TRUE:

• A. At the peak of a uterine contraction, uteroplacental circulation is interrupted for 15-60 seconds.
• B. Uterine artery blood flow decreases by 30% during uterine contractions.
• C. A decrease in oxygen levels is observed with normal-intensity and frequency contractions in cases of fetal distress.
• D. Uterine artery blood flow decreases by 30% during uterine contractions, and there is a decrease in fetal blood oxygen levels with normal contractions.

Answer: D

Note: A decrease in fetal blood oxygen levels can occur during contractions, especially when contractions are strong or frequent.

409. How does fetal heart rate typically change due to uterine contractions:

• A. At the beginning of a contraction, the fetal heart rate speeds up and then returns to normal until the contraction ends.
• B. At the beginning of a contraction, the fetal heart rate slows down, then speeds up, and returns to normal when the contraction ends.
• C. At the beginning of a contraction, the fetal heart rate speeds up, then slows down, and returns to normal when the contraction ends.
• D. At the beginning of a contraction, the fetal heart rate is normal, then speeds up when the contraction reaches its peak intensity, and returns to normal when the contraction ends.

Answer: C

Note: The changes in fetal heart rate during contractions are a normal physiological response.