Childbirth is the process of expulsion or removal from the uterus of a child and placenta (placenta, membranes, umbilical cord) after the fetus reaches viability. Normal physiological childbirth occurs through the natural birth canal. If the baby is delivered by caesarean section or obstetric forceps, or using other delivery operations, then such births are operative.
Typically, timely birth occurs within 38-42 weeks of obstetric period, counting from the first day of the last menstrual period. Wherein average weight a full-term newborn is 3300±200 g, and its length is 50-55 cm. Childbirth, which occurs at 28-37 weeks. pregnancy and earlier are considered premature, and more than 42 weeks. - belated. The average duration of physiological labor ranges from 7 to 12 hours for primiparous women, and from 6 to 10 hours for multiparous women. Labor that lasts 6 hours or less is called rapid, 3 hours or less - rapid, more than 12 hours - protracted. Such births are pathological.
Stages of physiological childbirth through the natural birth canal: development and maintenance of regular contractile activity of the uterus (contractions); changes in the structure of the cervix; gradual opening of the uterine pharynx up to 10-12 cm; advancement of the child through the birth canal and its birth; separation of the placenta and discharge of the placenta. There are three periods during childbirth: the first is the dilation of the cervix; the second is the expulsion of the fetus; the third is subsequent.
The first stage of labor lasts from the first contractions until the cervix is fully dilated and is the longest. For primiparous women, it ranges from 8 to 10 hours, and for multiparous women, 6-7 hours. In the first period there are three phases. First or latent phase the first stage of labor begins with the establishment regular rhythm contractions with a frequency of 1-2 per 10 minutes, and ends with smoothing or pronounced shortening of the cervix and opening of the uterine pharynx by at least 4 cm. The duration of the latent phase is on average 5-6 hours. In primiparous women, the latent phase is always longer than in multiparous women. During this period, contractions are usually not painful. As a rule, no drug correction is required during the latent phase of labor. But in women of late or young age, if there are any complicating factors, it is advisable to promote the processes of dilation of the cervix and relaxation of the lower segment. For this purpose, it is possible to prescribe antispasmodic drugs.
After the cervix dilates by 4 cm, the second or active phase the first stage of labor, which is characterized by intense labor and rapid opening of the uterine pharynx from 4 to 8 cm. The average duration of this phase is almost the same in primiparous and multiparous women and averages 3-4 hours. The frequency of contractions in the active phase of the first stage of labor is 3-5 per 10 minutes. Contractions most often become painful. Painful sensations predominate in the lower abdomen. During active behavior of a woman (standing position, walking) contractile activity the uterus increases. In this regard, they use drug pain relief in combination with antispasmodic drugs. The amniotic sac should open on its own at the height of one of the contractions when the cervix opens 6-8 cm. At the same time, about 150-200 ml of light and transparent amniotic fluid is poured out. If spontaneous discharge of amniotic fluid has not occurred, then when the uterine pharynx is dilated by 6-8 cm, the doctor must open the amniotic sac. Simultaneously with the dilation of the cervix, the fetal head moves along the birth canal. At the end of the active phase, the uterine os opens completely or almost completely, and the fetal head descends to the level of the pelvic floor.
The third phase of the first stage of labor is called deceleration phase. It begins after the uterine pharynx is dilated by 8 cm and continues until the cervix is fully dilated to 10-12 cm. During this period, it may seem that labor has weakened. This phase in primiparous women lasts from 20 minutes to 1-2 hours, and in multiparous women it may be completely absent.
During the entire first stage of labor, the condition of the mother and her fetus is constantly monitored. Monitor intensity and effectiveness labor activity, the condition of the woman in labor (well-being, pulse rate, breathing, blood pressure, temperature, discharge from the genital tract). The fetal heartbeat is regularly listened to, but most often constant cardiac monitoring is performed. During normal labor, the baby does not suffer during uterine contractions, and its heart rate does not change significantly. During labor, it is necessary to assess the position and advancement of the head in relation to pelvic landmarks. A vaginal examination during labor is performed to determine the insertion and advancement of the fetal head, to assess the degree of opening of the cervix, and to clarify the obstetric situation.
Mandatory vaginal examinations performed in the following situations: when a woman enters maternity hospital; when amniotic fluid ruptures; with the onset of labor; in case of deviations from the normal course of labor; before anesthesia; when bloody discharge from the birth canal. One should not be afraid of frequent vaginal examinations; it is much more important to ensure complete orientation in assessing the correct course of labor.
The period of expulsion of the fetus begins from the moment the cervix is fully dilated and ends with the birth of the child. During childbirth, it is necessary to monitor bladder and bowel function. Fullness of the bladder and rectum hinders normal flow childbirth To prevent the bladder from overflowing, the woman in labor is asked to urinate every 2-3 hours. In the absence of independent urination, catheterization is used. Timely emptying is important lower section intestines (enema before childbirth and during its protracted course). Difficulty or absence of urination is a sign of pathology.
Special attention deserves the position of a woman in childbirth. IN obstetric practice the most popular are back birth, which is convenient from the point of view of assessing the nature of the course of labor. However, the position of the woman in labor on her back is not the best for the contractile activity of the uterus, for the fetus and for the woman herself. In this regard, most obstetricians recommend that women in the first stage of labor sit, walk for a short time, or stand. You can get up and walk both with intact and emptied water, but provided that the fetal head is tightly fixed at the pelvic inlet. In some cases, it is practiced for a woman in labor to stay in a warm pool during the first stage of labor. If the location is known (according to ultrasound data), then the optimal one is position of the woman in labor on that side where the back of the fetus is located. In this position, the frequency and intensity of contractions does not decrease, the basal tone of the uterus is preserved normal values. In addition, studies have shown that in this position the blood supply to the uterus, uterine and uteroplacental blood flow improves. The fetus is always positioned facing the placenta.
It is not recommended to feed a woman in labor during labor for a number of reasons: the food reflex is suppressed during labor. During childbirth, a situation may arise in which anesthesia is required. The latter creates the danger of aspiration of stomach contents and acute disorder breathing.
From the moment the uterine os opens completely, the second stage of labor begins, which consists of the actual expulsion of the fetus, and ends with the birth of the child. The second period is the most critical, since the fetal head must pass through the closed bony ring of the pelvis, narrow enough for the fetus. When the presenting part of the fetus descends to the pelvic floor, contractions are joined by contractions of the abdominal muscles. Attempts begin, with the help of which the child moves through the vulvar ring and the process of his birth occurs.
From the moment the head is cut in, everything should be ready for delivery. As soon as the head has erupted and does not go deeper after pushing, they proceed directly to the delivery. Help is necessary because, while erupting, the head provides strong pressure to the pelvic floor and possible perineal ruptures. During obstetric care, the perineum is protected from damage; carefully remove the fetus from the birth canal, protecting it from adverse effects. When the fetal head is brought out, it is necessary to restrain its excessively rapid advancement. In some cases they perform perineal dissection to facilitate the birth of a child, which avoids failure of the pelvic floor muscles and prolapse of the vaginal walls due to their excessive stretching during childbirth. Usually the birth of a child occurs in 8-10 attempts. The average duration of the second stage of labor for primiparous women is 30-60 minutes, and for multiparous women it is 15-20 minutes.
IN last years in some European countries the so-called vertical birth. Proponents of this method believe that in the position of the woman in labor, standing or kneeling, the perineum is easier to stretch and the second stage of labor is accelerated. However, in this position it is difficult to monitor the condition of the perineum, prevent its ruptures, and remove the head. In addition, the strength of the arms and legs is not fully used. As for the use of special chairs for vertical childbirth, they can be classified as alternative options.
Immediately after the birth of the child, if umbilical cord is not compressed, and it is located below the level of the mother, then a reverse “infusion” of 60-80 ml of blood occurs from the placenta to the fetus. In this regard, the umbilical cord should not be crossed during a normal birth and the newborn is in satisfactory condition, but only after the pulsation of the vessels has stopped. In this case, until the umbilical cord is crossed, the child cannot be raised above the plane of the delivery table, otherwise a backflow of blood from the newborn to the placenta occurs. After the birth of the child, the third stage of labor begins - the afterbirth stage.
The third period (afterbirth) is determined from the moment of birth of the child until the separation of the placenta and the discharge of the placenta. In the afterbirth period, during 2-3 contractions, the placenta and membranes are separated from the walls of the uterus and the afterbirth is expelled from the genital tract. In all women giving birth in the afterbirth period, to prevent bleeding, intravenous drugs that promote uterine contraction. After birth, a thorough examination of the child and mother is carried out to identify possible birth injuries. During normal course afterbirth blood loss is no more than 0.5% of body weight (on average 250-350 ml). This blood loss is physiological, since it does not have a negative effect on the woman’s body. After expulsion of the placenta, the uterus enters a state of prolonged contraction. When the uterus contracts, its blood vessels are compressed and bleeding stops.
Newborns are given screening assessment for phenylketonuria, hypothyroidism, cystic fibrosis, galactosemia. After birth, information about the characteristics of childbirth, the condition of the newborn, recommendations maternity hospital transferred to the antenatal clinic doctor. If necessary, the mother and her newborn are advised by specialized specialists. Documentation about the newborn is sent to the pediatrician, who subsequently monitors the child.
It should be noted that in some cases, preliminary hospitalization in a maternity hospital is necessary to prepare for delivery. In the hospital, in-depth clinical, laboratory and instrumental examinations are carried out to select the timing and method of delivery. An individual birth management plan is drawn up for each pregnant woman (mother in labor). The patient is introduced to the proposed delivery plan. Obtain her consent to the proposed manipulations and operations during childbirth (stimulation, amniotomy, cesarean section).
C-section perform not at the woman's request, since this is an unsafe operation, but only by medical indications(absolute or relative). Childbirth in our country is not carried out at home, but only in an obstetric hospital under direct supervision medical supervision and control, since any childbirth is fraught with the possibility of various complications for the mother, fetus and newborn. The birth is led by a doctor, and the midwife, under the supervision of a doctor, provides manual assistance at the birth of the fetus and carries out the necessary treatment of the newborn. The birth canal is examined and repaired by a doctor if it is damaged.
Already assembled, ready, the whole family is waiting - when will the most crucial moment come? When is it time for mom(s) to go to the maternity hospital?
Childbirth usually begins with contractions - they mean that birth process has begun. To understand that labor is definitely underway and you need to hurry, it is useful to know at what interval the contractions come and how long they last. Let's talk about this in more detail!
- these are periodic involuntary contractions of the muscles of the uterus, characterized by increasing dynamics and intensity. They allow the cervix to open - the “exit” for the baby.
There are three stages (phases) of labor pains:
Each phase has its own duration, time intervals between contractions and the degree of dilatation of the cervix.
On average, the first phase of contractions lasts about 7-8 hours. At first they can last 10-15 seconds, with an interval of 15-30 minutes. By the end of this phase, the duration of the contraction can be 30-45 seconds, with an interval of approximately 5 minutes between them.
"During this time, the cervix opens up to 3 cm.
This phase is called hidden, since contractions in it are often painless, and you can simply not notice them - for example, “oversleep” or, conversely, not pay attention to the periodic tone, actively doing business.
During this period, you can finish urgent matters and get ready for the maternity hospital.
JK1986: In the evening, once every hour or two, pain in the lower abdomen made itself felt. It looked like a short spasm. It squeezed and immediately let go. I got ready. I shaved, washed, prepared and sorted the packages. Then the spasms became more frequent, once every half hour, but they were just as short-lived and, one might say, not painful. When these spasms became more noticeable and with an interval of 5-7 minutes, I went to surrender to the nurses. Then it became more frequent and more painful.
This phase lasts for first-time mothers from 3 to 5 hours. Uterine contractions become more frequent, prolonged and painful. Contractions in the second phase of labor last from 40 seconds to 1 minute. The interval between them in this phase can be from 5 to 2 minutes.
"By the end of the active phase, the dilation of the cervix already reaches 7 centimeters.
The onset of the active phase - that is, noticeable contractions with an interval of 5 minutes - suggests that you can no longer hesitate, you need to go to meet the baby!
By the time the cervix is fully dilated, the interval between contractions decreases to 2-3 minutes, and their duration, on the contrary, increases to 60 seconds. This means that the birth canal is almost or completely open and the pushing period of labor begins. At this stage, the woman may feel pressure on her anus and began to push.
The transition phase lasts from 30 minutes to 1.5 - 2 hours, and in women giving birth repeatedly, it can be practically absent, reduced to 2-3 contractions.
Why, exactly, are accurate calculations needed? Isn’t it enough to understand that they exist?
Firstly, at first - in order to make sure that the contractions are true, which means that the labor process has begun. After all, most expectant mothers are already familiar with pregnancy from the middle of pregnancy, and closer to childbirth the so-called training contractions are felt. But training contractions are irregular, and the interval between them is not reduced. Additionally, they usually stop completely within two hours.
The main signs of true ones are precisely their regularity and - an indispensable condition - increase in frequency, as well as an increase in duration.
zaichiha: On the day of birth I thought for a very long time whether I was having contractions or not. There were “training sessions” all morning. And I also thought there was a problem with my intestines. Then I decided that the training sessions were very intense, then I drank no-shpa, it didn’t help. And only when I began to suspect real contractions.
Secondly, with the help of calculations you can approximately determine what stage of labor you are at, which means whether it’s time to go to the maternity hospital, and maybe even those around you need to urgently prepare to give birth?!
Exist different points point of view on exactly when, at what intensity of contractions, the woman in labor should end up in the maternity hospital. This, of course, depends on the distance, traffic congestion and, of course, on whether this is the first birth. It must be borne in mind that during the second and subsequent births, the cervix usually opens about 4 hours faster than during the first!
Multiparous women do not need to wait; it is enough to understand that contractions occur regularly.
To begin with, note the time when you felt the first contraction, your doctor will need this. Then you need to arm yourself with a stopwatch or a watch with a second hand, paper and a pen. Note the time a contraction starts and the time it ends, and then the start and end of the next one. It might look something like this:
As the intensity of the contractions increases, the woman may become “not up to it” - at this time the husband or father can record the beginning and end of the contractions.
However, if a woman in labor is able to do this, she may well simply remember the intervals between the last contractions and their duration, without recording anything - the main thing is to have a watch at hand.
There are also special programs, which can be installed on your phone and can be used to count the number and duration of contractions. You just need to press a button at the beginning of the fight and another at the end, and the program itself will calculate the necessary data.
Although contractions are an indispensable condition natural birth However, the classic scheme does not always await a woman in labor. The above values should be considered average and applicable only to the normal course of labor.
And no tables guarantee that your particular contractions will proceed exactly as “should”: this is still an individual process. For example, contractions can progress from the very beginning until delivery, from two days to less than two hours! And after the water breaks, the contractions sharply intensify and become more frequent.
However, all phases of dilation inevitably occur in every birth.
“The reason that sometimes a woman gives birth “suddenly” is most often the painless nature of contractions in the first, and sometimes partially in the second phase of their labor.
Very often, contractions begin during sleep: the hormone oxytocin, which is responsible for their onset, is most actively produced at night. And they notice that they are giving birth, women in such cases are already closer to the period of pushing.
jelina: if there are contractions, then they cannot be confused with anything - I thought so until the second birth, when I realized that I was already giving birth, by pushing at an interval of 7 seconds. I just managed to jump from the prenatal to the birth room.
Little fashionista: There were no “increasing contractions”, strong contractions immediately began, 40 seconds at a time with an interval of 15 seconds, and so on for 6 hours. I periodically passed out from pain.
But even in such cases, counting contractions will be beneficial: the woman will understand that childbirth is very close, and she needs help.
And yet, most often, contractions increase gradually, giving to the expectant mother prepare for difficult work and the subsequent meeting with the baby!
Maceration of the skin of the feet and palms
Started
Miscarriage in progress
Aching pain in the lower abdomen
Vomiting of pregnancy
In any of the above periods
Apnea
Preeclampsia
Sulphacylic acid
25. Headache and changes in vision are characteristic of
1. Osteomalacia
2. Pregestosis
4. Nephropathies of the 2nd degree
26. In the second phase of eclampsia
1. Breathing is normal
2. Forced breathing
4. Tachypnea
27. An attack of eclampsia may develop
1. During pregnancy
2. During childbirth
3. In the early postpartum period
28. Toxicoses include
1. Hypertension
3. Hypotension
4. Proteinuria
29. A risk factor for the development of gestosis in pregnant women is
2. Age of primigravida 25 years
3. Second birth
4. Transverse position of the fetus
30. It is typical for a threatened miscarriage
1. Bleeding
4. Shortening of the cervix
31. Copious bleeding is characteristic of
1. Incipient miscarriage
3. Complete miscarriage
4. Threatened miscarriage
32. Next clinical stage miscarriage after threatening
2. Incomplete
33. A sign of postmaturity is
1. Weight 4000g.
2. Fetal hydrocephalus
3. Wide seams and fontanelles
34. Childbirth is considered late during pregnancy with a term
4. 295 days
35. Premature breaking of water is called
2. With the onset of labor
3. When the cervix opens 3 cm.
4. When opening 6 cm.
36. Stages of early spontaneous miscarriage
1. Threatening, abortion in progress, complete abortion
2. Threatened, begun, abortion in progress
3. Threatened, in progress, abortion in progress, incomplete abortion
4. Threatened, in progress, abortion in progress, incomplete or complete abortion
37. Premature birth- birth at term (in weeks)
38. A basin with external dimensions 23-25-28-18 is called
1. Transversely tapered
2. Flat-rachitic
3. Generally uniformly narrowed
4. Simple flat
39. The transversely narrowed pelvis has dimensions
40. Vasten’s sign indicates
1. Clinical discrepancy between the fetal head and maternal pelvis
2. Completed uterine rupture
3. Pregnancy
4. Placenta previa
41. A generally uniformly narrowed pelvis is characterized by
1. Thin bones
2. Uniform reduction of all sizes
3. Sharp pubic angle
4. All of the above
42. What form of narrowing of the pelvis corresponds to its dimensions (25-28-31-18)
1. Simple flat
2. Flat-rachitic
3. Generally uniformly narrowed
4. Generally narrowed flat
43. What shape of the pelvis corresponds to its dimensions (27-27-30-18)
1. Simple flat
2. Flat-rachitic
3. Generally uniformly narrowed
4. Generally narrowed flat
44. The degree of narrowing of the pelvis is determined by the conjugate
1. Outdoor
2. Anatomical
3. Diagonal
4. True
45. What is characteristic of a flat-rachitic pelvis?
1. Reduction of all direct dimensions
2. Reducing the direct size of the pelvic inlet
3. Reducing the direct size of the pelvic outlet
4. Reducing all sizes
46. The most typical thing for a twin pregnancy is
1. Post-maturity
2. Miscarriage
3. Development of large fruits
4. Violent labor
47. In a primigravida woman in labor
1. First comes the opening of the external pharynx
2. First comes the opening of the internal pharynx
3. Shortening and opening cervix goes simultaneously
4. First comes the opening of the cervix, and then its shortening
48. The second stage of labor is called the period
1. Cervical dilatation
2. Expulsion of the fetus
3. Preliminary
4. Follower
49. The point around which extension of the head occurs is called
1. Wired
2. Presenter
3. Fixation point
4. Reference point
50. The second stage of labor begins from the moment
1. Full dilatation of the cervix
2. Start of pushing contractions
3. Breaking water
4. The appearance of contractions after 3 minutes for 40 seconds
51. Lengthening the outer segment of the umbilical cord by 10 centimeters is called a sign of separation of the placenta
1. Alfelda
2. Shredder
3. Kustner-Chukalov
52. The set of movements that the fetus makes when passing through the pelvis and birth canal is called
1. Asynclitism
2. Configuration
3. Biomechanism
4. Contraction
53. A healthy postpartum woman has a fundus of the uterus on the 3rd day after birth
1. At the level of the navel
2. 1 cross finger below the navel
3. 3 transverse fingers below the navel
4. 1 transverse finger above the pubis
54. The average duration of labor for multiparous women is
2. 5-7 hours
3. 8-12 hours
4. 13-18 hours
1. Rush of amniotic fluid
2. Removal of the mucus plug
3. Pressing the head to the entrance to the pelvis
4. The appearance of regular contractions and smoothing of the cervix
56. Labor pains are characterized by
1. Frequency, duration, involuntary, painful and forceful contraction
2. Irregularity and involuntariness
3. A woman in labor can control her contractions.
4. Contraction of the uterus in the lower segment
57. Dilatation of the cervix in multiparous women occurs
1. From the external pharynx
2. Both jaws open simultaneously
3. Faster than multiparous women
4. The internal os opens, the neck is smoothed and the outer os closes
58. Permissible blood loss during childbirth is based on body weight
59. Duration postpartum period
1. 1 week
3. 2 weeks
4. 6-8 weeks
60. Reverse development of the uterus is
1. Implantation
2. Epithelization
3. Involution
4. Subinvolution
3. Serum
4. Ichor
62. A sign of intrauterine fetal hypoxia is
1. Cord noise
2. Increased fetal heart rate above 160 beats per minute.
3. Listening to the fetal heartbeat below the navel
4. Lack of fetal movement
63. During breech presentation, the heartbeat is heard
1. Below the navel
2. Above the navel
3. Above the womb
4. At the level of the navel
64. Conditions contributing to the development of acute fetal hypoxia
1. Pregnancy
2. The pregnant woman is over 30 years old
3. The pregnant woman is less than 16 years old
4. Prolapse of the umbilical cord loop
65. Pyuria and bacteriuria are a sign in a pregnant woman
1. Early gestosis
2. Late gestosis
3. Pyelonephritis
4. Diabetes
66. The occurrence of polyhydramnios or oligohydramnios is usually associated with dysfunction
1. Umbilical cords
2. Bladder
3. Amniotic epithelium
4. Myometrium
67. Most common complication pregnancy during diabetes mellitus
1. Low water
2. Pregnancy
3. Fetal malformations
4. Large size of the fruit
68. Weakness of labor is characterized by
1. Violation of the rhythm and intensity of uterine contractions
2. Excessive intensification of contractions
3. The presence of convulsive contractions of the uterus
4. Lack of coordination of contractions between the right and left halves of the uterus, its upper and lower parts
69. External bleeding in the absence of pain is typical for
1. Placental abruption
2. Placenta previa
3. Incipient miscarriage
4. Threatened miscarriage
70. Most likely placenta previa
1. During your first pregnancy
2. After several abortions
3. During the second pregnancy after normal birth
4. In a primigravida without a complicated medical history
71. If placenta previa is suspected, a vaginal examination can be performed
1. In the antenatal clinic
2. In the emergency room
3. In the prenatal ward
4. In a deployed operating room
72. “Cuveler’s uterus” appears
1. After every birth
2. Due to premature abruption of a normally located placenta
3. If labor is weak
4. In case of incoordination of labor
73. Sign hemorrhagic shock is
1. Frequent thready pulse
2. Increased blood pressure
4. Facial hyperemia
74. Premature abruption of a normally located placenta most often occurs when
1. Gestose
2. Inflammatory changes in the endometrium
3. Immunological conflict between mother and fetus
4. Breech presentation of the fetus
75. The risk group for developing hypotonic bleeding in the early postpartum period includes all postpartum women, except
1. Those whose childbirth was complicated by weakness of labor
2. Those who gave birth to a child weighing more than 4000g
3. Multiparous women
4. Those who have had premature rupture of amniotic fluid
5. Correction of protein balance
76. The main reason for the development of placenta previa
1. Dystrophic changes uterine mucosa
2. Multiple births
3. Polyhydramnios
4. Incorrect fetal position
77. Bleeding during placenta previa is characterized by
1. Blood clot release
2. Undulating, scarlet blood color, painless, causeless
3. Blood color is dark
4. Soreness
78. Clinical sign of premature abruption of a normally located placenta
1. Increased uterine tone, uterine asymmetry
2. The fetal heartbeat is clearly audible
3. No bleeding
4. The uterus is painless
79. The uterus takes shape “ hourglass" at
1. Threat of uterine rupture
2. In case of uterine rupture
3. During a normal contraction
4. Between contractions
80. A perineal rupture in which the rectum ruptures is called a rupture
1. 1st degree
2. 2 degrees
3. 3 degrees
4. 4 degrees
81. With a threatening rupture of the skin of the perineum
2. Blushes
3. Turns pale
4. Remains unchanged
82. Postpartum perineal ulcer refers to the stage of postpartum inflammatory diseases
83. Generalized septic infection includes
1. Postpartum ulcer
2. Parametrite
3. Septicemia
4. Pelvioperitonitis
84. With diffuse peritonitis, the symptom is positive
1. Crede-Lazarevich
2. Kustner-Chukalov
3. Gentera-Geghara
4. Shchetkin-Blumberg
85. The most common purulent-septic complication that develops in the postpartum period is
2. Endometritis
3. Pyelonephritis
4. Thrombophlebitis
86. Acute fetal hypoxia is characterized by
1. Heart rate 130 beats per minute.
2. Arrhythmia
3. Deafness of heart sounds
4. Heart rate 170 beats. per minute
87. Primary weakness of labor is characterized by
1. Painful contractions
2. Short contractions
3. Insufficient dynamics of cervical dilatation
4. Rapid advancement of the presenting part of the fetus
88. Clinical signs threat of uterine rupture
1. Violent labor
2. Bloody discharge from the genital tract
3. Overstretching and pain in the lower segment of the uterus
4. Hypertonicity of the uterus
89. Assessment of the fetal condition using the Apgar scale is carried out after birth through
90. Research methods to diagnose premature detachment normally located placenta
1. External obstetric examination
2. Auscultation of the fetal heartbeat
4. X-ray of the uterus
91. Bleeding with placenta previa is characterized by
1. Suddenness of occurrence
2. Pain in the lower segment of the uterus
3. Repeatability
4. Swelling of the perineum
92. Causes of bleeding in the early postpartum period
1. Rupture of the soft tissues of the birth canal
2. Strangulation of the placenta
3. Hypotony of the uterus
4. Retention of parts of the placenta in the uterus
93. Symptoms of pyelonephritis in a pregnant woman
1. Pain in the epigastric region
2. Pain in the lumbar region
4. Positive symptom Pasternatsky
94. Symptoms postpartum endometritis
1. Pain in the iliac regions
2. Pain in suprapubic region
3. Bloody-purulent suckers
4. Subinvolution of the uterus
95. A postpartum perineal ulcer is characterized by
1. Cyanosis of the perineum
2. Hyperemia of the perineum
3. Purulent discharge
4. Swelling of the perineum
96. Mastitis is promoted by
1. Milk stagnation
2. Hypogalactia
3. Cracked nipples
4. Flat nipples
97. Signs of placental separation
1. Alfelda
2. Kustner-Chukalov
4. Vastena
98. Vaginal examination during childbirth is carried out in order to
1. Definitions of integrity amniotic sac
2. Degree of cervical dilatation
3. Determination of the features of insertion of the fetal head
4. All of the above
99. What contributes to the occurrence clinically narrow pelvis
1. Weakness of labor
2. Early rupture of water
3. Post-term pregnancy
4. Malformations of the uterus
100. Termination of pregnancy at the request of a woman is allowed during pregnancy
1. Up to 14 weeks
2. Up to 22 weeks
3. Up to 12 weeks
- 314.50 KbA healthy person and his environment.
With duration menstrual cycle 28 days should be considered
Normative
Anteposing
Post-posing
Hyperponic
Pharmatex refers to the contraceptive method:
Hormonal;
Chemical;
Barrier;
Mechanical;
Physiological.
Gonadotropic hormones include:
Vasopressin.
From 1 kg to 2 kg;
From 2 to 3 kg;
From 3 to 4 kg;
From 4 to 5 kg;
Over 5 kg.
The hypothalamus produces:
Release factor;
What is the transverse position of the fetus?
The axes of the fetus and uterus are at right angles;
The axes of the fetus and uterus coincide;
The axes of the fetus and uterus are at an acute angle;
The axes of the fetus and uterus are at an obtuse angle.
What is the type of fetal position?
The relationship of the fetal back to the ribs of the uterus; "
The ratio of the back to the front or back wall uterus;
The relationship of the head to the ribs of the uterus;
The relationship of the back to the left side of the uterus.
What are contractions?
Contraction of the pelvic floor muscles;
Contraction of the abdominal muscles;
Rhythmic contraction of the uterus;
Reducing the diaphragm.
Prevention of bleeding during childbirth is carried out:
Progesterone;
Oxytocin;
Sinestrol;
Szigetin.
How is gonoblenorea prevented during childbirth?
Penicillin;
Furacilin;
Sulfacyl sodium 20%;
Sulfacyl sodium 10%.
Method for isolating the placenta according to Abuladze:
Squeezing the placenta with one hand;
Pressing with the edge of the palm over the pubis;
Take abdominal wall in a longitudinal fold;
Press on the fundus of the uterus with two fists;
Apply a clamp to the umbilical cord.
To determine the expected due date based on the last menstrual period, you must:
Add eight months to the first day of the last menstrual period
Subtract three months and add seven days
Subtract four months
Add nine months
The first pregnant woman feels the first movement of the fetus in
Eighteen weeks
Twenty weeks
Twenty two weeks
Sixteen weeks
Leopold's third technique determines
Fetal position
Fetal position
Presenting part of the fetus
Fetal heartbeat
Harbingers of childbirth
Regular, frequent contractions
Leakage of amniotic fluid
False contractions
Headache
The reason for the onset of labor is
Mature cervix
Generic dominant
Mature placenta
Overstretched uterus
Rush of amniotic fluid
False contractions
Pressing the head to the entrance to the pelvis
The appearance of regular contractions and smoothing of the cervix
Labor pains are characterized
Frequency, duration, involuntary, painful and force of contraction
Irregularity and involuntary
A woman in labor can control her contractions
Contraction of the uterus in the lower segment
While pushing
Intrauterine pressure decreases
Intra-abdominal pressure decreases
Intra-abdominal pressure increases
Abdominal muscles relax
Main component of the placenta
Adipose tissue
Villi
Connective tissue
Muscle
The afterbirth includes
Placenta and membranes
Chorion and amnion
Placenta, membranes and umbilical cord
Shells and umbilical cord
The vesicle in which the egg grows and matures
Lymphocyte
Follicle
Erythrocyte
Alveolus
A mass containing blood vessels that connects the fetus to the placenta
Spermatic cord
Umbilical cord
The fallopian tubes
The corpus luteum hormone progesterone promotes
Preservation of pregnancy, growth of mammary glands
Termination of pregnancy
Development of the egg
Follicle maturation
Questionable signs of pregnancy
Increased blood pressure
Perversion of taste and smell
Frequent urination
Sweating
Immunological tests are based on the detection
Corpus luteum hormones
Pituitary hormones
Estrogens
Human chorionic gonadotropin
Weight of the premature fetus (in grams)
During breech presentation, the heartbeat is heard
Below the navel
Above the womb
Above the navel
At navel level
Induced abortion is the termination of pregnancy before
15 weeks
12 weeks
10 weeks
Outer lining of the uterus
Parametrium
Perimetry
Myometrium
Endometrium
Normal vaginal flora
Epithelial cells
Dederlein sticks
E. coli
Formed in the ovaries
Enzymes
Sperm
Formed elements of blood
The mucous membrane of the fallopian tubes is lined with epithelium
Multilayer flat
Flickering
Cubic
Single row
Ovarian function:
excretory
Endocrine-hormonal
Protective
Menstrual
The uterine artery arises from
External iliac artery
Internal iliac artery
Genital artery
Play an important role in the regulation of the menstrual cycle
Hypothalamic-pituitary system
Pancreas
Thyroid
Parathyroid glands
The first menstruation in girls (menarche) normally begins at age
External genitalia:
Vagina
The fallopian tubes
Mammary gland
The space between the labia minora is called
Urogenital diaphragm
Crotch
Hymen
sex slit
Moistening of the vaginal opening during sexual arousal occurs due to
Sweating of blood vessels
Bartholin glands
Uterine secretion
Paraurethral glands
Internal genital organs
Bladder
Vagina
Pelvic fiber
The vagina has a normal environment
Neutral
Slightly alkaline
Alkaline
The paired tubular organ oviduct is
Vas deferens
Eustachian tubes
Ureters
The fallopian tubes
Uterine mucosa
Endothelium
Myometrium
Endometrium
Parametrium
Uterine function
Menstrual
Secretory
excretory
Protective
BRIGHT BLOODY LOCHIA AFTER DELIVERY DURING THE NORMAL COURSE OF THE POSTPARTUM PERIOD OCCURS
THE INTERNAL OPTION OF THE CERVIX IS FORMED
On day 3
After 10 days
In 3 weeks
A month later.
THE CERVIX IS COMPLETELY FORMED AFTER BIRTH
On day 3
A week later
In 3 weeks
2 months later.
1.5-2 months.
INCREASES LACTATION
Parlodel
Bromocriptine
Sinestrol
POSTPARTUM MATERNITY LEAVE WITH NO COMPLICATIONS
A HEALTHY PURPOSE WOMAN HAS A UTERINE FUNDON 3 DAYS AFTER BIRTH
At navel level
1 cross finger below the navel
3 cross fingers below the navel
1 transverse finger above the pubis.
THE FUNDUS OF THE UTERUS IS HIDDEN BEHIND THE PUBIS IN A HEALTHY PURPOSE WOMAN
On the 4th day
On day 7 5
On the 11th day
A month later.
CONTRACTIVE ACTIVITY OF MYOMETRIA IS STIMULATED BY INCREASED PRODUCTION
Prostaglandins
Progesterone
Prolactin
Parthusistena.
Rush of amniotic fluid
Pressing the head to the entrance to the pelvis
Cervical shortening
The appearance of regular contractions and smoothing of the cervix.
IN A PRIMUARY WOMAN IN LABOR
First comes the opening of the external pharynx
First comes the opening of the internal pharynx
The cervix shortens and dilates simultaneously
First comes the opening of the cervix, and then its shortening.
THE SECOND PHASE OF THE DISCLOSURE PERIOD IS CALLED
Latent
Active
Transitional
Preliminary.
TYPE OF CONTRACTION WHICH IS MORE CHARACTERISTIC FOR THE BODY OF THE UTERUS
Distraction
Retraction
Contraction
When erupting the parietal tubercles
With external rotation of the head
After the birth of the head
With positive signs of separation of the placenta.
UPPER LIMIT OF PHYSIOLOGICAL BLOOD LOSS DURING CHILDREN WITH A BODY WEIGHT OF 80 KG
0.5% of body weight
0.6% of body weight
1% of body weight
5% of body weight.
INSPECTION OF THE BIRTH CAN AFTER DELIVERY IS CARRIED OUT
Only women at risk
Only for first-time mothers"
Multiparous only
To all those who gave birth through the natural birth canal.
TO DETERMINE THE DATE OF BIRTH BY THE NEGELE FORMULA, YOU NEED TO SUBTRACT FROM THE STARTING DATE OF YOUR LAST MENSURE
2 months and add 7-10 days
3 months and add 7-10 days.
DURATION OF NORMAL PREGNANCY
ANTENATUAL MATERNITY LEAVE IS ISSUED FROM
12 weeks
20 weeks
30 weeks
32 weeks.
MULTIPARATE WOMEN START TO FEEL FETAL MOVEMENTS, MOST OFTEN, STARTING WITH
12 weeks.
18 weeks
22 weeks.
TERM OF PREGNANCY AT WHICH THE FUNDUS OF THE UTERUS IS IN THE MIDDLE OF THE DISTANCE BETWEEN THE NUMBER AND THE PUBIS
12 weeks
14 weeks
16 weeks
20 weeks.
DEGREE OF PREGNANCY AT WHICH THE FUNDUS OF THE UTERUS IS IN THE MIDDLE OF THE DISTANCE BETWEEN THE UMBILICUS AND THE xiphoid process
20 weeks
24 weeks
32 weeks.
38 weeks.
THE RELATIONSHIP OF THE FETAL BACK ANTERIOR OR POSTERIOR IS CALLED
Presentation
Regulations
Position
THE THIRD TECHNIQUE OF LEOPOLD-LEVITSKY ALLOWS YOU TO IDENTIFY
Fetal position
Fetal presentation
Fetal position
Position type.
A RELIABLE SIGN OF PREGNANCY IS
Enlarged uterus
Delay of menstruation
Breast enlargement
Listening to the fetal heartbeat.
Please indicate the average normal duration births in first-time mothers:
10-12 hours
18-20 hours
Indicate the average normal duration of labor for multiparous women:
What processes are atypical for the period of dilatation of normal labor?
Regular contractions.
Progressive dilatation of the cervix.
Regular pushing
Indicate the most traumatic way of releasing the placenta:
According to Abuladze
According to Genter
According to Crede-Lazarevich
According to Schroeder
What is not typical for the biomechanism of childbirth during front view occipital presentation?
Maximum head flexion.
Internal rotation of the head.
Head extension.
Prolonged standing of the head
Indicate the amount of physiological blood loss during childbirth:
Up to 0.5% body weight
1.0% body weight
Postpartum discharge
Blood serum
Formed elements of blood
During the postpartum period you need to pay special attention
Prevention of mastitis
Prevention of caries
Hand skin care
Mental state of the woman in labor
A birth tumor is
Displacement of fetal skull bones
Swelling of the soft tissues of the head
Hemorrhage of the soft tissues of the head
Skull bone tumor
Dilatation of the cervix in primiparous women occurs
From the external pharynx
Both openings open simultaneously
Faster than multiparous women
The internal os opens, the cervix is smoothed, then the external os opens
The period of expulsion of the fetus begins from the moment
Discharge of amniotic fluid
Full dilation of the cervix
When the head descends to the pelvic floor
The permissible blood loss during childbirth is based on body weight
Duration of the postpartum period
6-8 weeks
After childbirth, the uterus decreases in size due to
Reducing intrauterine pressure
Abdominal muscles
Contractions and atrophy muscle fibers uterus
Epithelization of the endometrium
Reverse development of the uterus is
Implantation
Epithelialization
Involution
Subinvolution
With menopausal syndrome, clinical symptoms are observed:
Vegetative-vascular
Bacteriuria
Epigastric pain
Hormone is produced in the corpus luteum
Oxytocin
Sinestrol
Folliculin
Progesterone
The maturation and development of the corpus luteum occurs under the influence of the pituitary hormone
Follicle-stimulating
Thyroid-stimulating
Adreno-corticotropic
Luteinizing
In the uterus, the secretion phase occurs under the influence of the ovarian hormone
Folliculina
Sinestrol
Progesterone
Testosterone
Male sex hormones
Testosterone
Thyroidin
Progesterone
Composition of the pelvic bone
Sacral Cape
pubic bone
Formed in the ovaries
Enzymes
Sperm
The egg and female sex hormones
Formed elements of blood
Ovarian function:
excretory
Endocrine-hormonal
Protective
Menstrual
The vaginal part of the cervix is normally covered with epithelium
Cylindrical
Flickering
Multilayer flat
Ferrous
BARTHOLIN'S GLANDS BELONG TO
Glands internal secretion in a man.
The external genitalia of a woman.
The internal genital organs of a woman.
REACTION OF THE VAGINAL ENVIRONMENT IS NORMAL
Short description
The work contains a test on "Medicine" with answers
Assessing possible signs of pregnancy
Vaginal examination data
Immunological pregnancy tests
Ultrasound data
2. Immunological pregnancy tests are based on determining:
Estrogen in urine
Progesterone in the blood
Placental lactogen
Luteinizing hormone
Human chorionic gonadotropin
3. Most important sign pregnancy during vaginal examination:
Softening in the isthmus area
Consolidation of the uterus during palpation
Asymmetry of one of the corners of the uterus
Increased size of the uterus
Increase in the size of the uterus in accordance with the period of delay of menstruation, its soft consistency
4. Establishing the gestational age is based on:
Determining the height of the uterine fundus
Ultrasound data
Vaginal examination data at the first visit to the gynecologist
All listed data
5. The height of the uterine fundus at 20 weeks of pregnancy – at:
Navel level
2 fingers above the navel
2 fingers below the navel
Midway between the navel and womb
6. Height of the uterine fundus at 36 weeks of pregnancy:
Halfway between the navel and the xiphoid process
Reaches the xiphoid process
2 fingers below the xiphoid process
7. Auscultation of fetal heart sounds becomes possible from pregnancy:
22 weeks - 16 weeks
20 weeks - 25 weeks
8. The fundus of the uterus at the level of the womb corresponds to the period of pregnancy:
13–14 weeks
9. A vaginal examination to determine the degree of maturity of the birth canal should be carried out during pregnancy:
36 weeks - 39–40 weeks
38–39 weeks - 40–41 weeks
10. Ultrasound during pregnancy allows you to determine:
Gestational age
Fetal position
Localization of the placenta and its pathology
Fetal malformations
Examination of a pregnant woman
Choose the correct answer
11. Leopold – Levitsky’s techniques allow you to determine:
Position, position and appearance of the fetus
Character of the presenting part
Fundal height of the uterus
12. The second Leopold-Levitsky technique determines:
Character of the presenting part
Position, position and appearance of the fetus
Relation of the presenting part to the inlet of the pelvis
Fundal height of the uterus
13. At 40 weeks of pregnancy and average fetal size, the height of the uterine fundus and abdominal circumference should correspond to:
105 and 38 cm - 95 and 32 cm + 90 and 32 cm
85 and 32 cm - 85 and 30 cm
14. Measuring the diagonal conjugate becomes impossible when the head is standing:
Pressed against the entrance to the pelvis
Fixed with a small segment at the entrance to the pelvis
In the pelvic cavity
On the pelvic floor
15. Based on the value of the diagonal conjugate, you can calculate:
Direct size of the pelvic inlet plane
True conjugate
External conjugate
Direct size of the wide part of the pelvic cavity
Direct size of the narrow part of the pelvic cavity
16. The position of the sagittal suture in the right oblique size and the small fontanel in the front left corresponds to:
Second position rear view
First position front view
17. The position of the sagittal suture in the left oblique size and the small fontanel in the front left corresponds to:
First position front view
First position rear view
Second position front view
Second position rear view
P. “a” – “d” are incorrect
18. Middle inner surface the pubis, the middle of the acetabulum, the articulation of the II and III sacral vertebrae limit the plane:
Entrance to the pelvis
Wide part of the pelvic cavity
Narrow part of the pelvis
Pelvic outlet
19. The transverse dimension equal to 10.5 cm corresponds to the transverse dimension:
Planes of entry into the pelvis
Wide part of the pelvis
Planes of the narrow part of the pelvis
Pelvic exit planes
20. The true conjugate must have a value of at least:
Diagonal conjugates
Vertical diagonal of a Michaelis rhombus
Horizontal diagonal of a Michaelis rhombus
External conjugates
22. The fetal head in a primigravida at 40 weeks should be located in relation to the pelvic planes:
Above the entrance to the pelvis
Pressed against the entrance to the pelvis
Fixed with a large segment at the entrance to the pelvis
In the narrow part of the pelvic cavity
23. Methods for assessing the condition of the intrauterine fetus include:
Fetal auscultation data
Counting the number of fetal movements during the day
Amnioscopy
Determination of hormone levels in the blood
Everything listed in paragraphs “a” – “d”
24. Amniocentesis during pregnancy helps in the diagnosis of:
Hemolytic disease of the fetus
Fetal malformations
Sex of the fetus
Fetal conditions
Everything listed in paragraphs “a” – “d”
25. The main criterion for assessing fetal maturity is:
Fruit length
Fruit weight
Gestational age
Apgar score
Condition of sutures and fontanelles
26. Term of the fetus is determined based on:
Fetal conditions
Body weight values
Gestational age
Signs physical development fetus
27. The most common placenta attachment in the uterus:
In the upper part of the uterus along the anterior wall
In the upper part of the uterus along the posterior wall
In the lower segment
In the fundus of the uterus
In the lateral parts of the uterus
28. Changes of cardio-vascular system during pregnancy include:
Physiological left ventricular hypertrophy
Increased cardiac output
Increase in heart rate
Horizontal position of the heart
Everything listed in paragraphs “a” – “d”
29. Changes in the uterus during pregnancy:
Hypertrophy of muscle fibers
Hyperplasia of muscle fibers
Lengthening every muscle fiber
Increased volume of the uterine cavity
Everything listed in paragraphs “a” – “d”
30. Amnioscopy during pregnancy allows you to determine:
Absence of amniotic sac
Amniotic fluid color
Front water quantity
Fetal condition
Everything listed in paragraphs “a” – “d”
Clinical course of labor
Choose the correct answer
31. Dilatation of the cervix occurs as a result of:
Contractions of the uterine muscle in the fundus
Contractions of the uterine muscle in the lower segment
Distraction of the lower segment of the uterus
Contraction, retraction and distraction of the muscle fibers of the uterus
32. Structural changes The cervix in first-time mothers during labor begins with:
Areas of the external pharynx
Areas of the internal pharynx
Dilatation of the cervix with simultaneous smoothing
33. Structural changes in the cervix during childbirth in multiparous women begin with:
Areas of the external pharynx
Areas of the internal pharynx
Dilatation of the cervix with simultaneous smoothing
Smoothing the cervix after dilation
34. It is not typical for an immature cervix:
Soft consistency
Its deviation towards the sacrum
Length 2–2.5 cm
Closed cervical canal
35. It is not typical for a mature cervix:
Length 1–1.5 cm
Soft consistency
Its deviation towards the womb or sacrum
Freely patent cervical canal
36. The rate of opening of the uterine pharynx in primigravidas:
1 cm per hour
2 cm per hour
3 cm per hour
3 cm in 2 hours
37. The rate of opening of the uterine pharynx in multiparous women:
1 cm per hour
2 cm per hour
3 cm per hour
3 cm in 2 hours
38. Vaginal examination during childbirth allows you to determine:
Condition of the cervix and integrity of the amniotic sac
Dynamics of cervical dilatation
The nature of the presenting part, features of insertion of the head
Dynamics of advancement of the presenting part along the birth canal
Features of the structure of the pelvis
Everything listed in paragraphs “a” – “e”
39. During childbirth it is necessary to constantly evaluate:
Complaints of a woman in labor
Condition of the cardiovascular system
Activity of labor and fetal condition
The nature of vaginal discharge
Everything listed in paragraphs “a” – “d”
40. Premature rupture of amniotic fluid is considered to be the breaking of water:
Before contractions start
IN active phase childbirth
When pushing appears
41. Early breaking of amniotic fluid is considered to be the breaking of water:
Before contractions start
When irregular contractions occur
When the cervix is dilated less than 6 cm
When pushing appears
42. Timely release of water should occur:
Before contractions start
When irregular contractions occur
When regular contractions occur
When the cervix is dilated less than 6 cm
When the cervix is dilated more than 6 cm
43. In the first stage of labor the following does not occur:
Shortening and smoothing of the cervix
Cervical dilatation
Discharge of amniotic fluid
Advancement of the fetus through the birth canal
Cutting into the presenting part of the fetus
Pressing the head to the entrance to the pelvis
The appearance of irregular contractions
The appearance of regular contractions
Leakage of amniotic fluid
The appearance of regular contractions, leading to shortening and smoothing of the cervix
45. The midwife begins to deliver:
With the beginning of pushing
From the time of complete opening of the uterine os
When cutting into the fetal head
When the fetal head erupts
46. When the uterine os is fully dilated, the fetal head:
Pressed against the entrance to the pelvis
Fixed with a small segment at the entrance to the pelvis
Fixed with a large segment at the entrance to the pelvis
On the pelvic floor
At all of the above levels
47. To create an energy background during childbirth, the administration of glucose and calcium chloride is carried out according to the following scheme:
200 ml of 5% glucose solution and 100 ml of 1%
300 ml of 5% glucose solution and 200 ml of 1% calcium chloride solution
20 ml of 40% glucose solution and 10 ml of 10% calcium chloride solution
40 ml of 40% glucose solution and 10 ml of 10% calcium chloride solution
48. Assessment of the condition of the fetus during childbirth is carried out on the basis of:
Fetal heart rates
Character of amniotic fluid
Cardiac monitoring
Functional tests and ultrasound data
All of the above
49. The tactics for managing the third stage of labor do not depend on:
Duration of labor
Newborn sizes
Complicated obstetric history
Conditions of the newborn
Duration of the water-free period
50. Signs of placental separation do not include:
Schroeder
Alfeld
Chukalov – Kustner
51. Schroeder’s sign is manifested by deviation of the uterus:
To the right and below the navel
To the right and above the navel
To the left and below the navel
To the left and above the navel
52. Alfeld’s sign appears:
Lengthening the outer section of the umbilical cord
Retracting the umbilical cord into the vagina while inhaling
Flattening of the uterus and deviation of its fundus to the right
The appearance of bloody discharge from the vagina
53. Isolation of unseparated placenta from the uterus is carried out using the following method:
Abuladze
Gentera
Crede – Lazarevich
Pulling on the umbilical cord
Manual separation and release of placenta
54. The Credet-Lazarevich maneuver is used for:
Discharge of unseparated placenta
Discharge of separated placenta
External separation of the placenta
55. After signs of placental separation appear, it is necessary to begin discharging the separated placenta:
Immediately after symptoms appear
In 5 minutes
In 10 minutes
In 20 minutes
In 30 minutes
56. The drug most often used at the time of eruption of the head to prevent bleeding during childbirth:
Oxytocin
Methylergometrine
Ergotal
Prostenon
57. Perineotomy is not performed for the purpose of prevention:
Development of fetal hypoxia during the expulsion period
Subsequent and early postpartum hemorrhage
Perineal muscle rupture
Development of rectocele and cystocele
58. During perineotomy, the following pelvic floor muscles are not dissected:
Outer layer muscles
Urogenital diaphragm
Levator ani muscle
Muscle that compresses the anus
59. A sign of maturity of a newborn is not:
The ratio of body weight to body length
Location of the umbilical ring
Condition of the external genitalia
Amount of cheese grease
Cyanosis of the skin
60. Assessment of a newborn’s condition using the Apgar scale does not include:
Heart rate
Respiration rate
Condition of the pupils
Muscle tone
Skin color
61. Meconium is present in a newborn during the first:
1–2 days - 4–5 days
2–3 days - 6–7 days
62. Heart rate in a newborn:
80–100 beats/min
100–120 beats/min
120–160 beats/min
160–180 beats/min
63. Hemoglobin value in a newborn:
80–100 g/l - 140–160 g/l
100–120 g/l + 160–180 g/l
120–140 g/l
64. Prevention of ophthalmoblenorrhea is carried out:
2% silver nitrate solution
3% silver nitrate solution
20% sodium albucid solution
30% sodium albucid solution
Furacilin solution
65. Risk group for pathological course births are made up of pregnant women:
With a burdened somatic and obstetric-gynecological history
In the presence of large fruit, polyhydramnios and multiple births
If there is a scar on the uterus
With all the listed complications
Normal postpartum period
Choose the correct answer
66. Duration of the early postpartum period:
67. The duration of the postpartum period is determined:
The appearance of the first menstruation
Involution of the cervix
Stopping discharge from the uterus
Duration of lactation
Involution of the uterus
68. Height of the uterine fundus after the birth of the fetus:
At navel level
2 fingers above the navel
2 fingers below the navel
Halfway between the womb and the navel
69. Height of the uterine fundus after the birth of the placenta:
At navel level
2 fingers above the navel
Halfway between the navel and womb
2 fingers below the navel
At the level of the womb
70. Height of the uterine fundus on the 1st day after birth:
At navel level
2 fingers above the navel
2 fingers below the navel
Halfway between the navel and womb
71. Height of the uterine fundus on the 5th day after birth:
Halfway between the navel and womb
2 fingers below the navel
3 fingers above the pubis
At the level of the upper edge of the womb
72. The following does not occur on the inner surface of the uterus after childbirth:
Rejection of decidual tissue
Epithelization of the placental site
Endometrial regeneration
Endometrial proliferation
Secretory transformation of the endometrium
73. The nature of lochia on the 5th day after birth (before discharge):
Bloody - mucous
Serous-sanguinary - purulent
Bloody-serous
74. Condition of the cervical canal on the 1st day after birth:
We pass for the hand
We pass for 2–3 fingers
Formed, external os closed
Formed, internal os closed
75. Cervical canal on the 10th day after birth:
We pass for one finger
We pass for 2 fingers
We pass to the area of the internal pharynx
76. Involution of the uterus after childbirth slows down with:
Childbirth with a large fetus
Long labor
Postpartum endometritis
All listed complications
77. Lactation begins under the influence of:
Placental lactogen
Progesterone
Estrogens
Prolactin
Luteinizing hormone
78. The onset of lactation is considered normal:
Immediately after birth
On the 1st–2nd day after birth
On the 3rd day after birth
On the 4th–5th day after birth
79. Lactostasis is characterized by:
Moderate breast engorgement
Increased body temperature with chills
Free milk separation
Significant uniform engorgement of the mammary glands
80. Full recovery endometrial structure after childbirth occurs through:
10–15 days
Choose the correct answer
81. Piskacek’s sign during vaginal examination reveals:
Hardening and contraction of the uterus
Comb-like protrusion on the anterior surface of the uterus
Softening of the isthmus
Significant enlargement of one of the corners of the uterus
82. Doubtful signs of pregnancy do not include:
Nausea and vomiting
Taste whims
Loss of appetite
Delayed menstruation
83. The upper edge of the pubis, innominate lines, the apex of the promontory limit the plane of the small pelvis:
Wide part
Narrow part
84. The lower edge of the pubic symphysis, the ischial spines, and the sacrococcygeal joint limit the plane of the pelvis:
Wide part
Narrow part
85. With anterior occipital presentation, the birth of the head occurs:
Small oblique size 9.5 cm
Small oblique size 10.5 cm
Medium oblique size 10.5 cm
Vertical size 9.5 cm
86. In the posterior view of the occipital presentation of the second position, the sagittal suture is located in:
Right oblique size
Medium oblique size
87. The height of the uterine fundus at the level of the navel is determined:
After the birth of the fetus
After separation of the placenta
After the birth of the placenta
On the 2nd day after birth
88. The small fontanel is a wire point for:
Anterior view of occipital presentation
Posterior view of occipital presentation
Frontal presentation
Anterior parietal presentation
89. Corpus luteum pregnancy:
Develops from a follicle
Secretes progesterone
Actively functions throughout pregnancy
90. The placenta does not synthesize:
Prolactin
Progesterone and estrogens
91. Examination method that poses minimal risk to the fetus:
Fetoscopy
Chorionic villus biopsy
Cordocentesis
Amniocentesis
92. The synthesis of human chorionic gonadotropin occurs in:
Adrenal glands
Pituitary gland
Ovaries
Placenta
93. Physiological pregnancy continues:
94. Duration quick birth in first-time mothers:
95. Physiological changes hemodynamics during pregnancy are characterized by:
Decreased circulating blood volume
Increasing circulating blood volume
Increased peripheral vascular resistance
96. Uterine arteries depart from:
Internal iliac arteries
Common iliac artery
External iliac artery
97. The biophysical profile of the fetus does not include an assessment of:
The nature of the fetal respiratory movements
Amount of amniotic fluid
Fetal muscle tone
Contractile stress test
Fetal motor activity
98. Examination of a pregnant or parturient woman begins with:
Abdominal palpation
Auscultation of the abdomen
Pelvic measurements
Examinations by systems and organs
99. In a woman with the right physique, the Michaelis diamond has the shape:
Geometrically regular rhombus
Triangle
Irregular quadrilateral
Vertically elongated quadrangle
100. Articulation of the fetus is:
The relationship of the fetal limbs to the body
Head to body ratio
Relationship various parts fetus
Relationship between the legs and buttocks of the fetus
101. In the second stage of labor, the fetal heartbeat is controlled:
After every attempt
Every 15 minutes
Every 10 minutes
Every 5 minutes
102. The abdominal circumference of a pregnant woman is measured:
At navel level
At the level of the xiphoid process
2 fingers below the navel
3 fingers above the navel
103. At the end of pregnancy in a primiparous woman, the cervix is normal:
Shortened - smoothed completely
Partially smoothed - saved
104. Vaginal examination during childbirth is carried out when:
Admission of a woman in labor to the hospital
Purpose of labor stimulation
The appearance of bloody discharge
Eruption of waters
All of the above situations
105. To assess the condition of the fetus during childbirth, the following is used:
Auscultation
Cardiotocography
Hormonal study
All listed methods
106. Ultrasound in obstetrics allows you to determine:
Location of the placenta and its pathology
Fruit size
Non-developing pregnancy
Fetal malformations
Everything listed in paragraphs “a” – “d”
107. The gestational age and date of birth cannot be determined by:
Date of last menstruation
Date of first fetal movement
Data from early attendance at the antenatal clinic
Ultrasound data
Fruit size
108. The tactics for managing the third stage of labor depend on:
Degrees of blood loss
Duration of labor
Presence of signs of placental separation
Conditions of the newborn
Duration of the water-free period
109. A sign of advanced labor is:
Outpouring of waters
Increasing frequency of contractions
Shortening and smoothing of the cervix
Increasing pain in the lumbar region
Pressing the head to the entrance to the pelvis
110. Reliable signs of pregnancy include:
Fetal movement
Increased size of the uterus
Vaginal cyanosis
Palpation of fetal parts
Increased rectal temperature
111. The largest volume of circulating blood during pregnancy is observed in:
Mid third trimester
Late second trimester
Childbirth period
Mid first trimester
Early second trimester
112. Malformations of the fetus in early dates pregnancy can cause:
Rubella
Tuberculosis
Chicken pox
Chronic hepatitis
Chronic adnexitis
113. The effectiveness of labor is objectively assessed by:
Frequency and duration of contractions
Duration of labor
Dynamics of cervical dilatation
Fetal condition
Time of rupture of amniotic fluid
115. Probable sign of pregnancy:
Changes in taste and smell
Palpation of fetal parts
Listening to the fetal heartbeat
Piskacek's sign
Nausea and vomiting in the morning
116. A reliable sign pregnancy is:
Delayed menstruation
Increased belly size
Nausea and vomiting
Presence of fetus in the uterus
The appearance of colostrum
117. Early diagnosis pregnancy is based on:
Changes in basal temperature
Determining the level of hCG in urine
Ultrasound data
Vaginal examination results
Diagnostic tests and all listed data
118. The preliminary period is characterized by:
Smoothing and dilation of the cervix
Regular labor
Irregular labor
Rush of amniotic fluid
Insertion of the amniotic sac into the cervix
119. During a developing pregnancy, the following does not occur:
Increased size of the uterus
Softening her
Changes in response to palpation
Uterine seals
Changes in the shape of the uterus
120. External obstetric examination in the second half of pregnancy does not imply:
Determining the position and size of the fetus
Anatomical assessment of the pelvis
Determination of gestational age
Functional assessment of the pelvis
Estimates of fetal heart rate and rhythm
121. The purpose of vaginal examination does not include:
Determination of the integrity of the amniotic sac
Fetal assessment
Determining the degree of cervical dilatation
Determining the nature of insertion of the fetal head
Pelvic size assessment
122. An indicator of the beginning of the second stage of labor is:
Finding the head on the pelvic floor
Full dilatation of the cervix
Head cutting
Set the sequence of actions
123. Examination of a pregnant woman:
1) determination of the presenting part of the fetus
2) determination of the position, position and type of the fetus
3) measurement of abdominal circumference, fundal height of the uterus
4) listening to the fetal heartbeat
5) determination of the standing level of the presenting part of the fetus
Answer: 3-2-1-5-4
124. During vaginal examination in the first stage of labor:
1) determine the degree of opening of the uterine pharynx
2) measure the diagonal conjugate
3) establish the presenting part
4) assess the condition of the vagina
5) determine the integrity of the amniotic sac
6) establish the location of the sagittal suture and fontanelles
Answer: 4-1-5-3-6-2
125. Diagnosis of pregnancy:
2) general inspection
3) medical history
4) special external and internal research
6) laboratory tests
Answer: 5-3-2-4-1-6
126. Vaginal examination of a pregnant woman:
1) determination of the condition of the pelvic bones
2) determining the nature of the presenting part
3) condition of the cervix and cervical canal
4) condition of the amniotic sac
5) vaginal condition
Answer: 5-3-4-2-1
127. Biomechanism of labor in anterior occipital presentation:
1) internal rotation of the head
2) insertion of the head and its bending
3) internal rotation of the shoulders, external rotation of the head
4) extension of the head
Answer: 2-1-4-3
128. Biomechanism of labor in the posterior view of the occipital presentation of the fetus:
1) internal rotation of the shoulders, external rotation of the head
2) internal rotation of the head
3) insertion of the head and its bending
4) additional flexion of the head
5) extension of the head
Answer: 3-2-4-5-1
129. The sequence of examination of a postpartum mother in the postpartum department:
1) the nature of lochia
2) assessment of general condition
3) clarification of complaints
4) examination and palpation of the mammary glands
5) palpation of the abdomen with determination of the height of the uterine fundus
Answer: 3-2-4-5-1
130. Management of the afterbirth period:
1) evaluate general state and volume of blood loss
2) inspect the afterbirth
3) release urine
4) determine the signs of separation of the placenta
5) put ice and a weight on your stomach
6) highlight the afterbirth
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