Abnormal Labor/Induction of Labor Flashcards
What does protracted labor mean?
- slower than normal progress of labor
What does arrested labor mean?
- complete cessation of progress
What medication is used to treat hypocontractile states (poor power)?
- pitocin (oxytocin)
How is “active phase arrest” diagnosed?
When a protraction disorder persists despite oxycotin therapy
How is arrested second stage defined?
no descent of the presenting part in >2hours in nullip and >1 hour in multip (without epidural)
*add 1 hour if epidural
T/F: You can use both a vacuum and forceps during the same operative vaginal delivery.
FALSE
never use both!
Why is it crucial to know the fetal position if performing an operational vaginal delivery?
- you don’t want to put a vacuum on a fontanelle
What gestational age marks the cut off for using a vacuum?
34 weeks
Patients with a previous C-section need to be delivered by repeat C-section at _____ weeks.
37
What is the current recommendation for delivering a breech presentation?
- C-section
The only way a face presentation can be completed is if the chin is in what position?
anterior position
What is a lotus birth?
practice of leaving the umbilical cord uncut after childbirth for 3-10 days
What are the 3 possible causes of dystocia (slow progress of labor)?
- poor uterine contractions
- malpresentations and malposition
- disproportion between fetal size/pelvic size
exclude poor contractions and malpresentation before making a diagnosis of disproportion
What is the biggest difference between a low transverse and classical C-section?
- low transverse you can have a trial of labor
- classical (vertical) you cannot
What is the biggest future risk after performing a c-section?
uterine rupture
- not as common if there has been >18 months since last pregnancy*
- more common in classical c-section*
What is the difference between induction and augmentation of labor?
- induction = artificial process of initiating labor before spontaneous onset
- augmentation = the stimulation of uterine contractions after spontaneous onset, but the progress is considered inadequate
What score is used to examine dilation of the cervix?
Bishop score
What Bishop score means that the cervix is not yet ready for labor?
< 6
What are the 2 natural methods of inducing labor?
- membrane stripping
- amniotomy
How does stripping the membrane induce labor?
- causes an increase in prostaglandins which increases contractions
What patients should not be given misoprostol?
- patients with previous cesarean delivery or major uterine surgery
T/F: There is no risk of autism with oxytocin administration.
True
