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Obstetrics and Gynecology · USMLE Step 2 CK

USMLE Step 2 CK OB/GYN: Labor and Delivery Complications

Fetal heart rate pattern interpretation and labor complication management scenarios tested on USMLE Step 2 CK.

33 cards · basic cards · AI-written, checked twice. Edit anything.

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What causes early decelerations in FHR tracings?
Fetal head compression
How do early decelerations relate in timing to uterine contractions?
They mirror the contraction: onset, nadir, and recovery coincide with the contraction's start, peak, and end
What causes variable decelerations in FHR tracings?
Umbilical cord compression
What is the characteristic shape of variable decelerations?
Abrupt onset and offset, with variable depth, duration, and shape (not mirroring contractions)
What causes late decelerations in FHR tracings?
Uteroplacental insufficiency
How do late decelerations relate in timing to uterine contractions?
Gradual onset after the contraction begins, nadir after the contraction's peak, and gradual return to baseline
What does a Category I FHR tracing indicate?
A normal tracing predictive of normal fetal acid-base status at the time of observation
What does a Category II FHR tracing indicate?
An indeterminate tracing, not predictive of abnormal fetal acid-base status but requiring continued surveillance
What tracing features define a Category III FHR pattern?
Absent baseline variability with recurrent late decelerations, recurrent variable decelerations, or bradycardia, or a sinusoidal pattern
What is the initial management approach for a Category III FHR tracing?
Start intrauterine resuscitation measures, and expedite delivery if there is no improvement
A sinusoidal FHR pattern is classically associated with which fetal condition?
Severe fetal anemia
In intrauterine resuscitation, how should the mother be positioned?
Left lateral decubitus position
What fluid intervention is part of intrauterine resuscitation?
An IV fluid bolus
What should be done with oxytocin during intrauterine resuscitation for a nonreassuring tracing?
Discontinue or decrease the oxytocin infusion
What supplemental measure is given to the mother during intrauterine resuscitation?
Supplemental oxygen

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