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Y3 Reproduction > Abnormal Labour > Flashcards

Abnormal Labour Flashcards

1
Q

when is a baby pre-term?

A

born <37 weeks

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2
Q

when is a baby post term?

A

born >42 weeks

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3
Q

what is obstruction of labour?

A

when there isn’t satisfactory progress in labour

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4
Q

what outlines the foetal vertex?

A

anterior fontanelle
posterior fontanelle
parietal eminences

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5
Q

name three possible types of malpresentation

A

breech
transverse lie
brow/face

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6
Q

what is transverse lie presentation?

A

when the baby is transverse in the uterus

arm/shoulder can prolapse through the cervix

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7
Q

what can increase the risk of a transverse lie?

A

pre-term
increased amniotic fluid
uterine abnormalities

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8
Q

what needs to be done if a baby presents in transverse lie?

A

c-section

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9
Q

what medications can be given for pain relief in labour?

A

entonox (inhaled)
IM opiates
IV remifentanil
epidural

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10
Q

what drugs are given in an epidural and give examples?

A

opiate and anaesthetic

morphine + levobupivacaine

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11
Q

what are some possible complications of an epidural?

A 
hypotension 
dural puncture 
headache 
high block 
atonic bladder
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12
Q

what is another name for obstructed labour?

A

failure to progress

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13
Q

what are some potential risks associated with obstructed labour?

A 
sepsis 
uterine rupture 
AKI
PPH 
fistula formation 
foetal asphyxia
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14
Q

what are some signs of obstructed labour?

A 
moulding 
caput 
anuria 
Haematuria 
vulval oedema
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15
Q

what is caput?

A

swelling of the foetal scalp

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16
Q

when should obstructed labour be suspected in a nulliparous woman?

A

<2cm dilatation in 4 hours

17
Q

when should obstructed labour be suspected in a parous woman?

A

<2cm dilatation in 4 hours OR slowing in progress

18
Q

what are the three causes of failure to progress?

A

power = inadequate contractions

passages = problems with the pelvis

passenger = problems with the foetus i.e. too big, malpresentation

19
Q

what three things are involved in an intra-partum foetal assessment?

A

doppler auscultation of the foetal heart
CTG
amniotic fluid assessment

20
Q

what does CTG stand for?

A

cardiotocograph

21
Q

what is stage 1 of doppler auscultation of the foetal heart?

A

during and after a contraction, every 15 minutes

22
Q

what is stage 2 of doppler auscultation of the foetal heart?

A

at least every 5 minutes during and after a contraction for one minute

check maternal pulse at least every 15 minutes

23
Q

name some risk factors for foetal hypoxia

A 
small foetus 
APH
hypertension
diabetes
epidural analgesia
24
Q

what should be done if any risk factors for foetal hypoxia are present?

A

continuous monitoring of the foetal heart

25
Q

name some acute causes of foetal hypoxia

A 
abruption
cord prolapse
uterine rupture 
vasa praevia
regional anaesthesia
26
Q

name some chronic causes of foetal hypoxia

A

placental insufficiency

foetal anaemia

26
Q

name some chronic causes of foetal hypoxia

A

placental insufficiency

foetal anaemia

27
Q

what four features need to be assessed when reviewing a CTG?

A

baseline foetal heart rate
baseline variability
presence/absence decelerations
presence/absence accelerations

28
Q

what are the three possible classifications for a CTG trace?

A

normal
suspicious
pathological

29
Q

what findings on a CTG suggest foetal hypoxia is developing?

A

loss of accelerations
repetitive deeper + wider decelerations
rising foetal baseline heart rate
loss of variablity

30
Q

what management would be done if there is an abnormal CTG?

A 
change maternal position
IV fluids
scalp stimulation
consider tocolysis
maternal assessment 
consider foetal blood sampling
31
Q

what drug should be stopped if there is an abnormal CTG trace?

A

syntocinon

32
Q

what should be done in a maternal assessment in an abnormal CTG?

A

pulse
BP
abdominal exam
VE

33
Q

what drug can be given for tocolysis?

A

terbutaline 250mg SC

34
Q

what does it mean if a foetuses scalp pH is >7.25 and what action needs to be taken?

A

normal

no action

35
Q

what does it mean if a foetuses scalp pH is 7.20 - 7.25 and what action needs to be taken?

A

borderline

repeat after 30 mns

36
Q

what does it mean if a foetuses scalp pH is <7.20 and what action needs to be taken?

A

abnormal

deliver the baby

Y3 Reproduction (49 decks)

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