Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > 9. Complications in Labor > Flashcards

9. Complications in Labor Flashcards

1
Q

Types of instrumental Delivery (3)

A

o Forceps Assisted Birth
o Vacuum-Assisted Birth
o Caesarean Section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Indications of instrumental delivery (4)

A
  • Maternal exhaustion
  • Ineffective pushing efforts
  • Expedite birth
  • Cephalopelvic Disproportion (CPD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classification of forceps is based on the station of the fetal head when the forceps are applied (4)

A
  • Outlet forceps: Fetal head on perineum
  • Low forceps: +2 station
  • Mid forcep: 0 to +2 station
  • High forceps: Above 0 station (not really done anymore)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Advantages of forceps

A

Shortens second stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risks of forceps (4)

A
  • Neonatal birth trauma (Facial palsy)
  • Neonatal respiratory depression
  • Postpartum hemorrhage
  • Bladder injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vacuum-Assisted Birth: Def

A

• Suction with soft or flexible cup on vertex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which is used more: Forceps or Vacuum?

A

Vacuum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risks of Vacuum-assisted birth (4)

A
  • Cephalohematomoa
  • Scalp lacerations
  • Subdural hematoma
  • Perineal trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

C-Section: Def

A

• Birth through transabdominal incision of uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is a C-Section done?

A

• Preserve life / health of mother and baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Indications for a C-Section (9)

A
  • Maternal or fetal distress
  • CPD

• Malpresentation (Breech or transverse lie)

  • Placental Previa or abruption
  • Prolapsed umbilical cord
  • Failed induction
  • Multi-fetal pregnancies
  • Pre-eclampsia / Eclampsia
  • Active herpes (HSV) infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Types of C-Sections (types of uterine incisions) (2)

A

Upper Uterine Segment:
o Classical

Lower Uterine Segment
o Low transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What types of c-sections enable VBACs later?

A

Classical - VBAC is contraindicated

Low Transverse - VBAC possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contraindications of C-Sections (3)

A
  • Fetal death
  • Fetus is not expected to survive
  • Maternal coagulation defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Maternal risks of C-sections (6)

A
  • Infection, Hemorrhage, UTI, Thrombophlebitis, Atelectasis

* Anesthesia Complications (Pnemonia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neonatal risks of C-sections (3)

A
  • Inadvertant Preterm birth
  • Lacerations
  • Bruising or other trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Major risk of VBAC

and prevalence

A

Uterine rupture (0.5% prevalence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Uterine rupture: Incidence

A

1 in every 1500 to 2000 births

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of uterine rupture (6)

A
  • Separation of the scar of a previous classic cesarean birth or uterine trauma
  • Congenital uterine anomaly
  • Intense spontaneous uterine contractions
  • Uterine stimulation (eg oxytocin)
  • An over-distended utuerus (eg multifetal gestation)
  • Malpresentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Classifications of uterine rupture (2)

A
  • Incomplete uterine rupture:

* Complete uterine rupture:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Incomplete uterine rupture (def)

A

• Rupture extends through the endometrium, myometrium but the peritoneum surrounding the uterus remains intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complete uterine rupture (def)

A

• Extends through the entire uterine wall (endometrium, myometrium and peritonium) and uterine contents spill into the abdominal cavity

23
Q

Retained placenta: Causes (3)

A
  • Partial separation
  • Abnormal adherence of placenta
  • Mismanagement of the 3rd stage of labor
24
Q

Management of retained placenta (3)

A
  • IV sedation or anesthesia
  • Manual removal of placenta
  • Prophylactic abx therapy
25
Q

Adherent placenta – 3 types / levels

A
  • Acreta
  • Increta
  • Percreta
26
Q

Placenta acreta

A

Slight penetration of myometrium (A-creta = A-little penetration)

27
Q

Placenta increta

A

Deep penetration of myometrium (In-creta = In- deep)

28
Q

Placenta percreta

A

Complete perforation of the uterus (Per-creta = Per-foration)

29
Q

Retained placenta: Predisposing factors (3)

A
  • Abnormal site of implantation (placenta grabs onto something abnormal)
  • Malformation of the placenta (not as common)
  • Scarring of the uterus
30
Q

What would cause scarring of the uterus? (4)

A
  • High parity (scarring of the uterus)
  • Previous cesarean section (scarring)
  • Previous myomectomy (from removal of fibroids)
  • Hx of vigorous curettage / perforation (scraping the lining)
31
Q

Cord Prolapse (def)
• What happens
• Two forms

A

o Cord lies below the presenting part of the fetus

o May be hidden (occult) or visible (frank)

32
Q

Cord prolapse: Management (3)

A
  • Keep pressure off cord
  • Keep moist with saline if it’s that visible
  • Birth by c- section
33
Q

How would you keep pressure off of a prolapsed cord?

A
  • Knee-chest position

* Hand in vagina

34
Q

Shoulder dystocia: Def

A

o Anterior shoulder cannot pass under the pubic arch of the maternal pelvis

35
Q

2 causes of shoulder dystocia

A
  • Macrosomia

* Pelvic anomolies

36
Q

Sxs of shoulder dystocia prior to birth (3)

A
  • Slowing of the progress of labor
  • Formation of caput that increases the size
  • After birth of head: Turtle sign
37
Q

Management of shoulder dystocia

(4 options)

A
  • Change pelvic diameter
  • Snap the clavicle
  • Suprapubic Pressure
  • McRobert’s Maneuver
38
Q

What is McRobert’s Maneuver?

A
  • Supine

* Knees to chest

39
Q

Maternal complications involved with shoulder dystoica (3)

A
  • Uterine atony / rupture: Increased blood loss
  • Vaginal lacerations
  • Uterine infection (endometritis)
40
Q

Neonatal complications involved with shoulder dystocia (3)

A
  • Clavicle fracture
  • Asphyxia → Seizure
  • Erb’s palsy: Brachial plexus damage
41
Q

PPH (def)

• Amounts

A

Greater than average blood loss:
• >500mL of blood after vaginal birth
• >1000mL after c-section

42
Q

Early versus late postpartum hemorrhage

A

o Early PPH: Occurs within 24 hours PP

o Late PPH: Occurs after 24 hours, but within 6 weeks

43
Q

Most common cause of postpartum hemorrhage

A

Uterine atony

44
Q

Other (less common) causes of postpartum hemorrhage (6)

A
  • Retained placenta
  • Uterine rupture or inversion
  • Cervical or vaginal lacerations
  • Hematomas
  • Infection (endometritis)
  • Coagulopathies
45
Q

Definition of uterine atony

A

Marked hypotonia of the uterus (along with distention, overstimulation or trauma to the uterus)

46
Q

Nursing management of uterine atony (4)

A

o Bimanual compression
o Pharmacologic interventions
o Uterine exploration
o Surgical interventions - historectomy

47
Q

What pharmacological management is used for uterine atony?

  • First line
  • Second line
A

o FIRST LINE: Pitocin

o SECOND LINE: Methergine

48
Q

Pitocin: Dose, routes

A
  • 10-40 units in 100mL LR

* Can also be administered IM

49
Q

Methergine: Dose, route,contraindicaitons

A
  • 0.2 mg IM

* Contraindicated in HTN / PIH

50
Q

Inversion of the uterus sxs (3)

A
  • Hemorrhage
  • Pain
  • Shock
51
Q

Postpartum infection: Def

A

Any infection that occurs within 28 days after miscarriage, ETOP and childbirth

52
Q

Postpartum infection: Clinical manifestation / diagnosis

A

• Fever is > or = to 100.4*F on two successive days of the first 10p days

53
Q

Common postpartum infections (5)

A 
o	Endometritis
o	Wound infection
o	Mastitis
o	UTI
o	URI
54
Q

Most common organisms for postpartum infections (2)

A

Streptococcal and anaerobic organisms

OB (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions