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Abnormal Labor

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

a. Bony-pelvis abnormalities

b. Inadequate expulsive forces

c. Soft-tissue abnormalities of the reproductive tract

d. All of the above

Which of the following is true regarding cephalopelvic disproportion?

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

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

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

d. B and C

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

a. Prominent coccyx

b. Contraction band in the lower uterine segment

c. Decreased anteroposterior diameter of the pelvic inlet

d. A and C

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.

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?

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

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

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

d. A and C

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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