Cervical Ripening

Cervical Ripening

Q. 1

What type of uterine contraction is responsible for cervical ripening ?

 A

A waves

 B

B waves

 C

Both

 D

None

Q. 1

What type of uterine contraction is responsible for cervical ripening ?

 A

A waves

 B

B waves

 C

Both

 D

None

Ans. D

Explanation:

None


Q. 2

Induction of abortion is best by :

 A

Oxytocin

 B

PGE2 gel

 C

Stripping of membrane

 D

Oestrogen

Q. 2

Induction of abortion is best by :

 A

Oxytocin

 B

PGE2 gel

 C

Stripping of membrane

 D

Oestrogen

Ans. B

Explanation:

PGE2 gel


Q. 3

Following is used in Ist trimester MTP :

 A

Mifepristone

 B

Laminaria tent

 C

Mifepristone & misoprostol

 D

b and c

Q. 3

Following is used in Ist trimester MTP :

 A

Mifepristone

 B

Laminaria tent

 C

Mifepristone & misoprostol

 D

b and c

Ans. D

Explanation:

b and c both


Q. 4

Which of the following is false regarding laminaria tent as a contraceptive?

 A

It is made from seaweed

 B

It is placed in the posterior fornix

 C

It is used for the dilatation of the cervix

 D

It has got a thread to facilitate removal

Q. 4

Which of the following is false regarding laminaria tent as a contraceptive?

 A

It is made from seaweed

 B

It is placed in the posterior fornix

 C

It is used for the dilatation of the cervix

 D

It has got a thread to facilitate removal

Ans. B

Explanation:

Laminaria tent is made from seaweed and is intensely hygroscopic.

It when placed in the cervix expands due to the hygroscopic action resulting in dilation of the cervix.

Ref: Mudaliar and Menon’s Clinical Obstetrics, 9th Edition, Page 517.

Q. 5

Mifepristone is an antiprogestin agent. All of the following are indications of using mifepristone, EXCEPT:

 A

Abortion

 B

Cushing’s syndrome

 C

PPH

 D

Cervical ripening

Q. 5

Mifepristone is an antiprogestin agent. All of the following are indications of using mifepristone, EXCEPT:

 A

Abortion

 B

Cushing’s syndrome

 C

PPH

 D

Cervical ripening

Ans. C

Explanation:

Therapeutic uses of Mifepristone:

  • Termination of early pregnancy
  • Cervical ripening
  • Postcoital contraceptive
  • Once a month contraceptive
  • Induction of labour
  • Cushing’s syndrome (because of its anti-glucocorticoid activity)
Ref: Essentials of Medical Pharmacology by KD Tripathi, 5th edition, Page 283-284.

Q. 6

All of the following are indications for using RU 486, EXCEPT:

 A

Post-coital contraception

 B

Cervical ripening

 C

Induction of labour

 D

MTP

Q. 6

All of the following are indications for using RU 486, EXCEPT:

 A

Post-coital contraception

 B

Cervical ripening

 C

Induction of labour

 D

MTP

Ans. C

Explanation:

Misoprostol (PGE1) and dinoprostone (PGE2) are two forms of prostaglandins are commonly used for cervical ripening before induction at term.

RU-486 or mifepristone is an anti-progestin. It acts primarily as a competitive receptor antagonist for both progesterone receptors. Indications for its usage are,
  • Termination of pregnancy
  • Emergency contraception
  • Prevention of conception
  • Induction of labor
  • For treatment of uterine leiomyomas, endometriosis, meningiomas, and breast cancer.
Ref: Levin E.R., Hammes S.R. (2011). Chapter 40. Estrogens and Progestins. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e.

 


Q. 7

All of the following drugs are used for cervical ripening during pregnancy, EXCEPT:

 A

Prostaglandin E2

 B

Oxytocin

 C

Progesterone

 D

Misoprostol

Q. 7

All of the following drugs are used for cervical ripening during pregnancy, EXCEPT:

 A

Prostaglandin E2

 B

Oxytocin

 C

Progesterone

 D

Misoprostol

Ans. C

Explanation:

Cervical ripening refers to a series of events taking place in the cervix during labour. Ripe cervix is shortened, softened, partly dilated and central in position. Pharmacologic drugs used for ripening of cervix are prostaglandin E2, misoprostol (PGE1), oxytocin and mifepristone. Progesterone is not indicated in ripening of cervix.

Ref: Maternity, Newborn, and Women’s Health Nursing: Comprehensive Care Across the Lifespan By Susan A. Orshan, Page 653


Q. 8

The following drugs/methods are used for cervical ripening, except?

 A

Oxytocin

 B

PGE

 C

Stripping of membrane

 D

Ergometrine

Q. 8

The following drugs/methods are used for cervical ripening, except?

 A

Oxytocin

 B

PGE

 C

Stripping of membrane

 D

Ergometrine

Ans. D

Explanation:

Prostaglandins, oxytocin, and stripping of membranes are usually done for cervical ripening. Other methods are Foley bulb catheter, early amniotomy, and late amniotomy. Ergometrine is used in promoting of contraction and involution of uterus after delivery.


Q. 9

A full term primipara comes with bleeding PN. Next line of management is :

 A

PN examination

 B

Conservative management till onset of labour

 C

Lower segment cesarean section

 D

Examination in OT followed by amniotomy

Q. 9

A full term primipara comes with bleeding PN. Next line of management is :

 A

PN examination

 B

Conservative management till onset of labour

 C

Lower segment cesarean section

 D

Examination in OT followed by amniotomy

Ans. D

Explanation:

Examination in OT followed by amniotomy


Q. 10

In bishop score all are included except

 A

Effacement of cervix

 B

Dilatation of cervix

 C

Station of head

 D

Interspinal diameter

Q. 10

In bishop score all are included except

 A

Effacement of cervix

 B

Dilatation of cervix

 C

Station of head

 D

Interspinal diameter

Ans. D

Explanation:

Ans. is d i.e. Interspinal diameter


Q. 11

Bishops score includes:

 A

Dilatation of cervix

 B

Effacement

 C

Cervical softening

 D

All of the above

Q. 11

Bishops score includes:

 A

Dilatation of cervix

 B

Effacement

 C

Cervical softening

 D

All of the above

Ans. D

Explanation:

Ans. is a, b, c and  i.e. Dilatation of cervix; Effacement; Cervical softening; and Position of head

Bishop score is a quantitative method for prediction of successful induction of labour. It includes the following parameters :

Cervical Dilatation

Cervical Position

Cervical Effacement

Head Station

Cervical Consistency

Mnemonic : Delhi Police Employed Special Commandos.

Bishop scoring in detail

Score

Dilatation (cm)

Effacement (%)

Station*

Cervical Consistency

Cervical Position

0

Closed

0 — 30

— 3

Firm

Posterior

1

1 — 2

40 — 50

— 2

Medium

Midposition

2

3 – 4

60 – 70

– 1, 0

Soft

Anterior

3

>5

>80

+1, +2

 

 

 

* Station reflects a –3 to +3 scale.

  • Induction of labour is successful with a score of 9 or more and is less successful with lower scores.
  • A score of < 4 means ripening of cervix is indicated.



Q. 12

Bishop scoring is based on all except :

 A

Dilatation of cervix

 B

Effacement of cervix

 C

Uterine contraction

 D

Station of head

Q. 12

Bishop scoring is based on all except :

 A

Dilatation of cervix

 B

Effacement of cervix

 C

Uterine contraction

 D

Station of head

Ans. C

Explanation:

Uterine contraction


Q. 13

Bishop scoring of more than…………………. indicates labour has begun :

 A

3

 B

5

 C

6

 D

7

Q. 13

Bishop scoring of more than…………………. indicates labour has begun :

 A

3

 B

5

 C

6

 D

7

Ans. C

Explanation:

6


Q. 14

All of the following are methods of Induction of labour except :

 A

Estrogen

 B

Oxytocin

 C

Stripping of membrane

 D

PGE7

Q. 14

All of the following are methods of Induction of labour except :

 A

Estrogen

 B

Oxytocin

 C

Stripping of membrane

 D

PGE7

Ans. A

Explanation:

Estrogen


Q. 15

All are used for cervical ripening, except :

 A

Ergometrine

 B

Oxytocin

 C

Stripping of membranes

 D

Prostaglandins

Q. 15

All are used for cervical ripening, except :

 A

Ergometrine

 B

Oxytocin

 C

Stripping of membranes

 D

Prostaglandins

Ans. A

Explanation:

Ergometrine


Q. 16

Which one of the following methods for induction of labour should not be used in patient with previ­ous lower segment caesarean section?

 A

Prostaglandin Gel

 B

Prostaglandin tablet

 C

Stripping of the membrane

 D

Oxytocin drip

Q. 16

Which one of the following methods for induction of labour should not be used in patient with previ­ous lower segment caesarean section?

 A

Prostaglandin Gel

 B

Prostaglandin tablet

 C

Stripping of the membrane

 D

Oxytocin drip

Ans. B

Explanation:

Prostaglandin tablet


Q. 17

Bishop’s classification is used for: 

March 2005

 A

Progress of labour

 B

Requirement of induction for labour

 C

Gestational age of fetus

 D

Fetal well bein

Q. 17

Bishop’s classification is used for: 

March 2005

 A

Progress of labour

 B

Requirement of induction for labour

 C

Gestational age of fetus

 D

Fetal well bein

Ans. B

Explanation:

Ans. B: Requirement of induction for labour


Q. 18

Which of the following is not a parameter in Bishop’s score:  

March 2009

 A

Cervical consistency

 B

Station of head

 C

Position of head

 D

Cervical length

Q. 18

Which of the following is not a parameter in Bishop’s score:  

March 2009

 A

Cervical consistency

 B

Station of head

 C

Position of head

 D

Cervical length

Ans. C

Explanation:

Ans. C: Position of Head


Q. 19

Elements of bishop’s score is all except ‑

 A

Cervical dilatation

 B

Cervical effacemat

 C

Endometrial consistency

 D

Fetal station

Q. 19

Elements of bishop’s score is all except ‑

 A

Cervical dilatation

 B

Cervical effacemat

 C

Endometrial consistency

 D

Fetal station

Ans. C

Explanation:

Ans. is ‘c’ i.e., Endometrial consistency

  • Bishop score, also Bishop’s score, also known as cervix score is a pre-labor scoring system to assist in predicting whether induction of labor will be required.
  • The total score is achieved by assessing the following five components on vaginal examination:
  • Cervical  dilation
  • Cervical effacement
  • Cervical consistency
  • Cervical position
  • Fetal station
  • If the Bishop score is 8 or greater the chances of having a vaginal delivery are good and the cervix is said to be favorable or “ripe” for induction.
  • If the Bishop score is 6 or less the chances of having a vaginal delivery are low and the cervix is said to be unfavorable or “unripe” for induction

Q. 20

Bishop scoring is done for ‑

 A

Exchange transfusion in newborn

 B

Induction of labour

 C

Ventilation of Newborn

 D

Gestation of Newborn

Q. 20

Bishop scoring is done for ‑

 A

Exchange transfusion in newborn

 B

Induction of labour

 C

Ventilation of Newborn

 D

Gestation of Newborn

Ans. B

Explanation:

Ans. is ‘b’ i.e., Induction of labour

  • Bishop score, also Bishop’s score, also known as cervix score is a pre-labor scoring system to assist in predicting whether induction of labor will be required.

The total score is achieved by assessing the following five components on vaginal examination:

  • Cervical dilation
  • Cervical effacement
  • Cervical consistency
  • Cervical position
  • Fetal station
  • If the Bishop score is 8 or greater the chances of having a vaginal delivery are good and the cervix is said to be favorable or “ripe” for induction.
  • If the Bishop score is 6 or less the chances of having a vaginal delivery are low and the cervix is said to be unfavorable or “unripe” for induction.


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