Intrapartum Management & Labor Support Flashcards
6 cards from real Certified Midwife Exam Prep practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Intrapartum Management & Labor Support flashcards as text
Which fetal presentation requires cesarean delivery and cannot be safely delivered vaginally?
Answer: Transverse lie
Transverse lie (shoulder presentation) is incompatible with vaginal delivery and requires cesarean section.
A primigravid patient has been pushing for 3 hours with epidural analgesia and the fetal head is at +2 station. What is the most appropriate next step?
Answer: Consult for operative vaginal delivery or cesarean if no progress
ACOG guidelines define arrested second stage as >3 hours of pushing with an epidural in a nulliparous patient, warranting operative delivery assessment.
Which intervention is part of active management of the third stage of labor (AMTSL)?
Answer: Administration of oxytocin after delivery of the anterior shoulder
AMTSL includes administration of a uterotonic (oxytocin 10 IU IM/IV) with delivery of the anterior shoulder to reduce postpartum hemorrhage.
A patient delivers and has an estimated blood loss of 600 mL after a vaginal birth. How is this classified?
Answer: Postpartum hemorrhage (PPH)
Postpartum hemorrhage is defined as blood loss ≥500 mL following vaginal delivery, making 600 mL a PPH by definition.
Which mnemonic is used to identify the four most common causes of postpartum hemorrhage?
Answer: The 4 Ts (Tone, Trauma, Tissue, Thrombin)
The 4 Ts—Tone (uterine atony), Trauma (lacerations), Tissue (retained placenta), and Thrombin (coagulopathy)—are the primary causes of PPH.
What is the normal duration of the latent phase of labor in a nulliparous patient?
Answer: Up to 20 hours
The latent phase in nulliparous patients can last up to 20 hours before being considered prolonged, per ACOG guidance.
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