Obstetrics Quiz: Diagnosing Labor

Note: The questions and answers below are for reference only. Diagnosing labor should be done by an obstetrician based on clinical examination, ultrasound, fetal monitoring, and necessary tests.

1. During the pushing stage, fetal heart rate should be monitored:

A. Every 30 minutes.

B. Every 15 minutes.

C. Every 5 minutes.

D. After each pushing contraction.

Answer: D. After each pushing contraction.

Explanation: During the pushing stage, close fetal heart rate monitoring after each pushing contraction is essential to detect abnormalities like fetal distress, heart rhythm disturbances, enabling timely interventions to safeguard both mother and baby’s health.

2. Choose the most likely scenario: When gestation is over 38 weeks, a pregnant woman experiences pink mucus discharge. This could be a sign of:

A. Placenta previa.

B. Labor.

C. Placental abruption.

D. Stillbirth.

Answer: B. Labor.

Explanation: Pink mucus discharge after 38 weeks of gestation is a potential sign of labor as the mucus plug in the cervix detaches. However, a definitive diagnosis requires considering other symptoms like abdominal pain, vaginal bleeding, and cervical dilation.

3. The amniotic sac is formed at:

A. Week 36 of pregnancy.

B. Week 38 of pregnancy.

C. During pre-labor.

D. When labor begins.

Answer: D. When labor begins.

Explanation: The amniotic sac, which encases the fetus and amniotic fluid, develops throughout pregnancy. Upon labor onset, cervical dilation and increased uterine pressure lead to the rupture of the amniotic sac and the release of amniotic fluid.

4. Choose the INCORRECT statement about stage 1a of labor:

A. Stage 1a begins when labor starts and ends at 3 cm cervical dilation.

B. Fetal descent may not progress during this stage.

C. The cervical dilation rate in this stage typically reaches 1 cm/hour.

D. This stage can last several hours.

Answer: C. The cervical dilation rate in this stage typically reaches 1 cm/hour.

Explanation: Cervical dilation during stage 1a can vary among women. The rate of 1 cm/hour is more common in stage 1b, when dilation ranges from 3 cm to 7 cm.

5. The mucus discharge during labor originates from:

A. Vaginal squamous epithelium.

B. Cervical squamous epithelium.

C. Glandular epithelium of the cervical canal.

D. Perimetrium.

Answer: C. Glandular epithelium of the cervical canal.

Explanation: The mucus discharge, known as the mucus plug, is secreted from the glandular epithelium of the cervical canal. It functions as a protective barrier against infections and seals off the cervix, preventing bacteria from entering the uterus.

6. The best time to examine for ruptured membranes is:

A. When the cervix is dilated.

B. During a uterine contraction.

C. Between contractions.

D. When amniotic fluid leaks.

Answer: B. During a uterine contraction.

Explanation: Examining during a contraction allows for increased uterine pressure, facilitating the detection of a ruptured amniotic sac and confirming the presence of amniotic fluid.

7. When fetal heart rate remains above 160 beats/minute or below 110 beats/minute for over 10 minutes, it could indicate:

A. Severe fetal distress.

B. Risk of fetal acidosis.

C. Potential fetal demise.

D. No evidence of fetal distress.

Answer: B. Risk of fetal acidosis.

Explanation: Sustained abnormal fetal heart rate variations can be a sign of fetal distress, including fetal acidosis. Continuous monitoring and prompt interventions are necessary to protect the baby’s health.

8. A 28-year-old woman, Para 1.0.2.1 (previous vaginal delivery, baby weight 3000g, healthy), is currently 39 weeks pregnant. She presents to the hospital for lower abdominal pain. Examination reveals normal general condition, uterine contractions on monitoring about 10 minutes apart, fetal heart rate 150 beats/minute, cervix long, slightly open externally, internal os closed, estimated fetal weight 3100g – 3200g. The previous prenatal visit, 3 days ago, showed similar results. She feels uncomfortable and wants to deliver immediately. What is your diagnosis?

A. Labor is progressing well.

B. Prolonged labor.

C. Labor is uncertain.

D. Stage 1 of labor.

Answer: C. Labor is uncertain.

Explanation: Based on the information provided, labor is not yet established. The cervix is still long, the internal os is closed, and the contractions are not regular or strong. Her discomfort could be related to other causes, and further evaluation is needed.

9. The average duration of labor for a primipara (first-time mother) is approximately:

A. 8 – 12 hours.

B. 12 – 16 hours.

C. 16 – 20 hours.

D. 16 – 24 hours.

Answer: D. 16 – 24 hours.

Explanation: The average labor duration for a primipara is typically 16-24 hours, although individual experiences can vary greatly based on factors like age, health, fetal size, and previous deliveries.

Note: This information is for reference only. Diagnosis and treatment should be performed by an obstetrician.