114 - Pregnancy Flashcards
What does G1P0 mean?
Primigravida
G1 = 1st pregnancy P0 = no children
What does G5P1 ^+3
Multigravida
G5 = 5th pregnancy P1 = one baby born ^+3 = 3 lost before 24 weeks (ectopic, termination, miscarriage)
What do you write to express someones pregnancies if they are post menopausal/not pregnancy?
Just P3
What is a term pregnancy?
37-42/52 weeks
What is a partogram?
A graphic representation of progress in labour
What does a partogram show?
Fetal HR Liquor Moulding Decent of head Oxytocin Contractions per 10 min Cervix diabeter
What is the scar you get from a normal CS/
Pfannensteil
What is striaw gravidarum?
Stretch marks
Linea negra
Dark line down midline
When is a babies head engaged?
When the majority of head is in the pelvis, when 2/5, 1/5 or 0/5 fifths are palpable per abdomen.
What is the normal position of the fetal head?
In relation to the mother
Normal = DOA - Direct occipital anterior
What is ‘face to pubes’?>
DOP
What is the fetal diameter of the head in DOA and DOP?
DOA = Suboccipital bregmatic = 9.5cm
DOP = Occidental frontal = 10.5-11.5cm
What is the station of the fetal head?
Where in relation to the ischial spines
-1 = 1cm above
0 = at level
+1 = 1cm below
+3 -> delivery
How many stages are there in labour? What are they vreifly?
3
1) Onset of labour
2) Full dilation - delivery of baby
3) Delivery - expulsion of placenta + membranes
What occurs in the 1st stage of labour?
Latent - contractions to the cervix is fully effaced (shortens )
Active - Cervix dilates at the external os
What occurs in 2nd stage of labour?
Propulsive: from full dilation (10cm) to head reaching pelvic floor
Expulsive - irresistible desire to bear down/push to deliver the baby
What occurs in the 3rd stage of labour?
The cord lengthens, there is a gush of blood, the fundus of the uterus rises
How do you deliver the placenta?
CCT- controlled cord traction
- pull cord to help bring placenta out
use the Brandt-Andrews method, with hand on abdo to stop uterus inverting.
What is the operculum?
A show - blood stained mucous discharge
What difficulties can a primigravida have in childbirth?
Unique psychological experience
Insufficient uterine action
Risk of cephalopelvic disproportion
What difficulties can a multigravida have in childbirth?
Risk of uterine rupture - due to hormones from previous preganancy
Describe the route of the baby in labour
Head decends at pelvic brim LOL NEck flexes Head hits pelvic floor and rotates DOA Head decends and delivers by extension Head restitutes Shoulders rotate (anterio-posterior diameter) Anterior shoulder slips under the pelvis Born with lateral flexion
Which drugs are used during labour?
Syntocin
Ergometrine
Syntometrine
What is/does syntocinon do?
It is synthetic oxytocin
- rhythmical uterine contractions
Acts in 2 minutes if given IM
What does ergometrine do?
Causes sustained, tetanic contractions
Used in PPH (postpartum haemorrage)
Acts in 40s, 30 mins activity
What does syntometrine do?
For active management of 3rd stage
reduces blood loss
Quicker placental delivery
Everyone in UK given
What is used in post partum haemorrhage every 15mins intramuscularly up to maximum of 8 doses.
Carboprost (15 alpha-methyl prostaglandin)
What do they use Prostin (dinoprostone)
for?
Ripen the cervix.
