VINAYAKA MISSION’S COLLEGE OF NURSING-KARAIKAL

MODEL EXAMINATION
MIDWIFERY & OBSTETRICAL NURSING
IV YEAR [Link]., NURSING
TIME: 3 HRS
MARKS: 75+
SECTION –A
[Link] ALL QUESTIONS EACH IN ONE OR TWO SENTENCES: 1X15=15

1. Define labour .
Labor is defined as regular and painful uterine contraction that cause progressive
dilatation and effacement of the cervix
2. List down the obstetrical emergencies condition .

o Abruption of the placenta.

o Placenta praevia.
o Postpartum haemorrhage.
o Amniotic fluid embolism.
o Inversion of uterus.
o Infection.
o Psychological conditions.
o Stillbirth and intrauterine death.

3. Define shoulder dystocia .

Shoulder dystocia is an obstetric emergency where the anterior fetal shoulder becomes
stuck on the maternal public symphysis, delaying the birth of the baby’s body . The most
common findings include slow delivery of the fetal head or chin and the turtle sign.

4. Define Low birth weight .

MUYGF Low birth weight (LBW) is defined as a birth weight of less than 2500g(up
to and including 2499g) , as per the World Health Organization (WHO)
5. Function of oxytocin.
The two main physical functions of oxytocin are to stimulate uterine contraction in
labour and child birth and to stimulate contractions of breast tissue to aid in lactation
after childbirth.
6. Difference between Hind Milk & Fore Milk .

‌Fork milk is the milk that your baby drinks at the beginning of a feeding and hindmilk
follows [Link], foremilk is mostly water combined with other nutrients, and
hindmilk is highly fatty.
7. What is pregnancy confirmatory test ?
The human chorionic gonadotrobin (Hcg)test is also known as the pregnancy test.
This test measures the amount of the hormone hCG in your urine or blood. The hCG
test can be used to both confirm and monitor a pregnancy. hCG is usually present only
when a female is pregnant.
8. Define cleiodotomy & Evisceration .
CLEIDOTOMY is surgical division of the clavicles to effect delivery of a fetus with
broad shoulders. [Link] act of removing the bowel or viscera: the act of
cutting so as to cause the viscera to protrude. synonyms: disembowelment. type of:
remotion, removal. the act of removing.

9. Define Partograph.
A partogram is used to record all observations made when the women is in [Link]
records the following points. The progress of labor is monitored by cervical dilatation,
descent of head and uterine contractions.
10. Define Perinatal Morbidity.
Perinatal mortality (PNM) is the death of a fetus or neonate and is the basis to
calculate the perinatal mortality rate.[1] Perinatal means "relating to the period starting
a few weeks before birth and including the birth and a few weeks after birth
11. Listdown the Tocolytic Agents.
Drugs that prevent preterm labor and immature birth by suppressing uterine
contractions (TOCOLYSIS). Agents used to delay premature uterine activity include

 Betamimetics (such as terbutaline)

 Magnesium sulphate
 Prostaglandin inhibitors (like indomethacin, ketorolac)
 Calcium channel blockers (such as nifedipine)
 Nitrates (like nitro-glycerine)

[Link] Augmentation .

In medical terms, augmentation means adding (augmenting) a medication or other

treatment to improve outcomes. With augmentation of labor, your healthcae provider
uses medications or other methods to aid your labor and delivery

[Link] is ovulation

Ovulation is a phase in the menstrual cycle when your overy releases an egg (ovum) .
Once an egg leaves your ovary, it travels down your fallopian tube where it waits to
be fertilized by sperm.
12. Define Ophthalmia Neonatorum
acute inflammation of the eyes of a newborn from infection during passage through
the birth canal. Symptoms include red eyes, pus in the eye and swollen eyelids.
Though rare, severe infections can cause blindness
13. Define inevitable miscarriage?.
Inevitable miscarriage refers to unexplained vaginal bleeding and abdominal pain
during early pregnancy. Signs and Symptoms: Bleeding is heavier than with a
threatened miscarriage and abdominal cramps more severe.

SECTION –B

II .WRITE SHORT NOTES ON ANY SIX OF THE FOLLOWING: 6X5=30

1. Role of a nurses in family welfare programme.

A Nurses plays as many roles in family welfare programmes:
[Link]’s Role
[Link] role
[Link] role
[Link] in Research worker
[Link] of clinical nurse in hospital/community
[Link] role
2. Objectives of antenatal care
 Maintain the health of the mother during pregnancy.
 Promote physical, mental, and social well-being of mother and child.
 Ensure delivery of a full-term healthy baby.
 Identify high-risk cases and provide appropriate management.
 Prevent the development of complications.

3. Induction of Labour .
induction of labor (IOL) is a common obstetric intervention that stimulates the onset of labor
using artificial methods
4. Manual removal of Placenta.
Manual placenta removal is the evacuation of the placenta from the uterus by
hand. It is usually carried out under anesthesia or more rarely, under sedation and
analgesia. A hand is inserted through the vagina and cervix into the uterine cavity and
the placenta is detached from the uterine wall and then removed manually.

1. Draw a sterile glove over your existing glove on your dominant hand.
2. Fold a sterile towel on the mother's abdomen with the opening facing you.
3. Draw the uterus downward and hold it stable with your hand.
4. Feel for an edge of the placenta and sweep your hand back and forth to separate it
from the uterine wall.
5. Proceed slowly until the placenta is completely detached.

[Link] .
 A forceps delivery is a form of assisted vaginal delivery which may sometimes be
needed in the course of vaginal childbirth. Forceps is an instrument consisting of 2
metal ladle-like devices, (shaped like a pair of large spoons or salad tongs with a
curve to snugly fit around the baby’s head), which are maneuvered to cradle and grasp
the baby’s head and help guide the baby out of the birth canal.

Forceps are used to assist the delivery of a baby as an alternative to the vacuum
extraction method.

guidelines after a forceps delivery procedure

While using the forceps to assist in the delivery of the baby If the doctor had made an
incision between the vagina and the anus during the delivery (episiotomy), or you had a
vaginal tear there are a few things you can do to accelerate your healing:

 Ask the nurse to apply ice packs in the area of the wound right after birth. Once you
come back home from the hospital continue using ice packs in the area.
 Use sitz baths a few times in a day once you get home from the hospital. This will
provide relief from the pain.

 While urinating keep pouring warm water over the area, this will take away the sting
of the urine.
 While passing stool do not put too much pressure. In fact, you can use a clean pad to
firmly push against the wound during a bowel movement.

 After urinating or after a bowel movement spray some warm water in the area and pat
dry using very soft towels or baby wipes. Do not use toilet paper or rub the area hard.
 While sitting down use a doughnut cushion

[Link].

Pregnancy: In late pregnancy, the uterine tissues have increased numbers of

prostaglandins — including PGE2 and PGE2a. They are likely responsible for
uterine contractions that move the fetus through the birth canal during labor. For this
reason, doctors may prescribe prostaglandin medications to induce childbirth.

[Link] of lactation
 he normal physiology of lactation is a process that begins to take effect well before
the initial latch of the newborn infant. It requires the breast to change in composition,
size, and shape during each stage of female development. Development includes
puberty, pregnancy, and lactation.

SECTION –C

[Link] ANY THREE OF THE FOLLOWING: (3X10=30)

1. (a) Define caesarian section. (2)

A caesarean section (c-section or ‘caesarean’) is a surgical procedure in which a baby
is born through an incision (cut) made in the mother’s abdominal wall and the wall of
the uterus (womb). Your baby will need to be born by caesarean section if there are
problems that prevent the baby being born by a normal vaginal birth.

(b) List out the indications of caesarian section. (2)

(labor dystocia, abnormal fetal heart rate pattern, malpresentation of the fetus,
multiple gestations, and suspected fetal macrosomia) and mitigation of how these
factors.
(c) Explain the pre and post operative nursing management of mother (6)
undergoing caesarian section.
Preoperative Assessment

A nursing assessment of a pregnant woman about to undergo a cesarean birth is also

important to obtain a health history that would become essential later on.

 Assess the woman about past surgeries, secondary illnesses, allergies to foods
or drugs, reaction to anesthesia, and medications that could increase any
surgical risk.
 The woman should be in the best possible physical and psychological state
before undergoing any surgery.
 An obese woman with poor nutritional status is at risk for slow wound healing.
 Tissue that contains extra fatty cells would be difficult to suture and the
incision will heal much slower and predispose the woman to infection and
dehiscence.
 An obese woman would also have difficulty in initiating ambulation and
turning after surgery as it will increase the risk
for pneumonia or thrombophlebitis.
 Postpartal Care

 The postpartal care period of a woman who has undergone emergent cesarean
birth is divided into two: immediate recovery period and extended postpartal
period.
 After surgery, the woman would be transferred by stretcher to the
postanesthesia care unit.
 If spinal anesthesia was used, the woman’s legs are fully anesthetized so she
cannot move them.
 Pain control is a major problem after birth because it was so intense that it
interfered with the woman’s ability to move and deep breathe.
 This may lead to complications such as pneumonia or thrombophlebitis.
 Use a pain rating scale to allow a woman to rate her pain.
 Some women may need patient-controlled analgesia or continued epidural
injections to relieve the pain.

2 .Explain about pregnancy induced hypertension (10)

Sometimes high blood pressure begins before pregnancy. In other cases, the condition
develops during pregnancy.

 Chronic hypertension. In chronic hypertension, high blood pressure develops

either before pregnancy or during the first 20 weeks of pregnancy. Because high
blood pressure usually doesn't have symptoms, it might be hard to know exactly
when it began.
 Chronic hypertension with superimposed preeclampsia. This condition occurs
when chronic hypertension leads to worsening high blood pressure during
pregnancy. People with this condition may develop protein in the urine or other
complications.
 Gestational hypertension. People with gestational hypertension have high blood
pressure that develops after 20 weeks of pregnancy. There's no excess protein in
the urine and there are no other signs of organ damage. But in some cases,
gestational hypertension can eventually lead to preeclampsia.
 Preeclampsia. Preeclampsia occurs when hypertension develops after 20 weeks
of pregnancy. Preeclampsia is associated with signs of damage to other organ
systems, including the kidneys, liver, blood or brain.

3. (a) Define abortion (2)

Abortion is a simple health care intervention that can be effectively managed by a

wide range of health workers using medication or a surgical procedure. In the first 12
weeks of pregnancy, a medical abortion can also be safely self-managed by the
pregnant person outside of a health care facility (e.g., at home),
 (b) Classification of abortion (2)

There are several types of abortion, including medical abortion, vacuum aspiration,
dilation and evacuation, and induced labor.

(c) Explain about missed and septic abortion (6)

MISSED ABORTION: is also known as a missed miscarriage or spontaneous abortion.

It’s a miscarriage in which the fetus didn’t form or is no longer developing, but the placenta
and embryonic tissues are still in your uterus.

SEPTIC ABORTION: a pregnancy loss accompanied by an intrauterine infection.

Although uncommon, septic abortion can be life threatening, with a fatality rate of 0.4 to 0.6
per 100,000 first-trimester pregnancy losses. Elevated temperature, leukocytosis, lower
abdominal pain, cervical motion tenderness, and a purulent vaginal discharge are all signs of
septic abortion. Infection can spread from the endometrium through the myometrium and
eventually affect the parametrium and peritoneum. The cause is most often polymicrobial.

4. (a) Define infertility (2)

0infertility is a condition of your reproductive system that causes people to be unable
to get pregnant .
(b) List the causes of infertility. (2)

Infertility may be caused by a number of different factors, in either the male or female
reproductive systems. However, it is sometimes not possible to explain the causes of
infertility.

In the female reproductive system, infertility may be caused by:

 tubal disorders such as blocked fallopian tubes, which are in turn caused by untreated
sexually transmitted infections (STIs) or complications of unsafe abortion, postpartum
sepsis or abdominal/pelvic surgery;
 uterine disorders which could be inflammatory in nature (such as such endometriosis),
congenital in nature (such as septate uterus), or benign in nature (such as fibroids);

(c) Explain about ART (6)

ART refers to treatments and procedures that aim to achieve pregnancy.

These complex procedures may be an option for people who have already gone through
various infertility treatment options but who still have not achieved pregnancy. Those
interested in ART should discuss the options with their health care provider and may need to
consult a fertility specialist.