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Producers seldom have the technical experience to judge the quality of computer programming, or a programming team, by themselves When a product is being developed out-of-house, someone at the publisher needs to be able to check the development company s code to make sure it meets software engineering standards, and to advise the producer on technical issues This person is a technical director sometimes called a technical producer or technical advisor A TD is usually a senior software engineer with a broad range of experience, possibly including some management However, within a publisher, on an external development project, a TD is not a managerial position It s primarily advisory, although it does come with some authority One of the TD s tasks is to check each milestone delivery to make sure that the code is up to snuff If it isn t, the TD can advise the producer not to authorize the next milestone payment In addition to examining the code and advising the producer, the TD also serves as an emergency resource for the developers With his experience, he can lend a hand where needed, helping to track down particularly difficult bugs and solving other technical problems He also recommends particular technical approaches or libraries of routines, and helps to get the developers coding resources and tools they may need Finally, a TD plays an important role in checking out new development teams that the publisher is considering working with He ll read the programmers r sum s, talk to them about their experience, and look over their gear and facilities He ll also examine the proposed technical design of a product that the developer is pitching to the publisher to see if it s really feasible or just pie-in-the-sky All this is critically important to a publisher who s considering investing millions of dollars in a group of people.

What is dystocia and what is its incidence Abnormal labor; occurs in approximately 25% of nulliparous women Advanced maternal age Non-reassuring fetal heart tracing Epidural anesthesia Macrosomia Occiput posterior position Nulliparity Short stature High station with full dilatation Chorioamnionitis Post-term pregnancy Obesity What are the three major categories of causes of dystocia What is meant by abnormal power What is meant by abnormal passage Problems with the three P s: power, passage, and passenger Inadequate or uncoordinated contractions Abnormal size or shape of maternal pelvis leading to cephalopelvic disproportion (a disproportion between the fetal head and maternal pelvis) Malposition, malpresentation, macrosomia, or multiple gestations Protraction disorders slower than normal progress Arrest disorders complete cessation of progress Name and describe two of the major causes of failure to progress Uterine hypocontractility: the most common cause of failure to progress; refers to uterine activity that is not strong enough or is not coordinated enough to dilate the cervix; quantified as uterine contractions <200 Montevideo units

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Epidural anesthesia: leads to an increased duration of the first and second stages of labor and an increased incidence of fetal malposition What are the criteria for the diagnosis of abnormal labor in each of these categories Duration of labor: Protracted dilation: Arrest of descent (with epidural): Arrest of descent (without epidural): When is an arrest of dilation diagnosed Nullipara >247 hours <12 cm/hr >3 hours >2 hours Multipara >188 hours <15 cm/hr >2 hours >1 hour

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Cessation of dilation after 4 cm or more despite adequate uterine contractions (>200 Montevideo units for 2 hours or more) With an amniotomy (if membranes are intact) and/or oxytocin (for hypocontractile uterine activity) Cesarean delivery she is in active phase arrest A latent phase (in the first stage of labor) of over 20 hours for a nullipara or 14 hours for a multipara Increased risks of cesarean delivery Newborn requiring NICU admission Thick meconium Depressed apgars

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