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Abnormal Labor

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Which of the following may be responsible for dystocia in labor?

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a. Bony-pelvis abnormalities

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b. Inadequate expulsive forces

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c. Soft-tissue abnormalities of the reproductive tract

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d. All of the above

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Which of the following is true regarding cephalopelvic disproportion?

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a. It currently is responsible for 34% of dystocia cases.

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b. It is a term that originated in the 1960s to describe abnormal bony pelves.

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c. It was defined during a time when dystocia developed secondary to vitamin D deficiency or rickets, which is now rare in developed countries.

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d. B and C

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In this diagram below, what represents the biggest obstacle to labor and delivery?

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a. Prominent coccyx

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b. Contraction band in the lower uterine segment

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c. Decreased anteroposterior diameter of the pelvic inlet

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d. A and C

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Reproduced with permission from Cunningham FG, Leveno KJ, Bloom SL, et al (eds): Abnormal labor. In Williams Obstetrics, 24th ed. New York, McGraw-Hill, 2014, Figure 23-1. C. R. = contraction ring, Ext. = external, Int. = internal.

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The National Institute of Child Health and Human Development (NICHD) and American College of Obstetricians and Gynecologists (ACOG) have made recommendations concerning the diagnosis of arrested second-stage labor. Which of the following statements are consistent with their recommendations?

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a. Arrested labor in the second stage should not be diagnosed until adequate time has elapsed.

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b. Before this diagnosis is given, nulliparas without epidural anesthesia should be allowed 2 hours without progress.

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c. Before this diagnosis is given, nulliparas without epidural anesthesia should be allowed 3 hours without progress.

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d. A and C

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At Parkland Hospital, neonates delivered from parturients whose second-stage labor lasted > 3 hours had which of the following adverse outcomes compared with neonates of mothers with shorter second-stage labor?

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