56 Obstetrics and Gynecology Board Review •••
❍ Of the patients identified with risk factors, how many of these will result in a poor outcome?
Twenty percent of patients identified with risk factors may account for >50% of poor outcomes.
❍ What percentage of patients are identified with risk factors when they present in labor?
An additional 5% to 10% will be identified at this time.
❍ How many of these will result in poor outcomes?
These patients account for approximately 20% to 25% of poor outcomes.
❍ What percentage of patients with a poor outcome have no identifiable risk factors?
20%.
❍ What are the goals of assisted spontaneous deliveries?
Assisted spontaneous deliveries should result in decreased maternal trauma and decreased fetal injury.
❍ What are the “proposed advantages” of routine episiotomy?
The “proposed advantages” include easier repair of a surgical incision, reduction in the second stage of labor,
and reduction in trauma to the pelvic floor musculature.
❍ What are the “proposed disadvantages” to episiotomy?
The “proposed disadvantages” include increased blood loss, increased maternal pain and unnecessary surgical
incision.
❍ What are the four types of the pelvic shapes?
Gynecoid, anthropoid, android, and platypelloid.
❍ What are Leopold maneuvers?
Palpation of the uterus to determine fetal lie and position.
❍ What is the definition of prolonged latent phase?
The latent phase is defined as prolonged if this period lasts >20 hours in a nulliparous patient or >14 hours in a
multiparous patient.
❍ What is the most common treatment of prolonged latent phase of labor?
Maternal rest.
❍ What percentage of patients will proceed to active labor following maternal rest?
Approximately 85% will proceed to active labor and approximately 10% will stop having contractions.
❍ How is dysfunctional labor defined?
Dysfunctional labor is defined when the active phase of dilatation is in the <5th percentile.