Abnormal labour Flashcards
Analgesic methods in labour?
Support Massage Entonox TENS Water immersion IM Opiate IV Remifentanil
Aetiology of labour pain?
Compression of para-cervical nerves
Myometrial hypoxia
Which medication is used in an epidural?
Levobupivacaine +/- opiate
Complications of epidural?
Atonic bladder Headache Back pain Hypotension Dural puncture-rare
Reasons of failure to progress with regards to 3Ps
Power- Inadequate contraction: Frequency and or strength
Passage: Short stature, trauma, shape
Passenger: Big baby, malposition
Which observations make up the partogram?
Fetal heart Amniotic fluid Cervical dilatation Descent Contractions Obstruction Maternal OBS
Intra-partum fetal heart assesment?
Doppler auscultation of fetal heart
CTG
Color of amniotic fluid
Risks for fetal hypoxia?
Preterm Pre eclampsia DM Epidura Haemorrhage
Acute causes of fetal distress?
Abruption
Uterine rupture
Cord prolapse
Vasa Praevia
Management of fetal distress?
Change maternal position
IV fluid
Stop syntocinon
Scalp stimulation
Consider tocolysis
Maternal assessment
Fetal blood sampling
Operative delivery
Indications for Operative delivery?
Delay
Fetal distress
Maternal cardiac disease
Severe PET/Eclampsia
Intrapartum haemorrhage
Umbilical cord prolapse
Disadvantages of ventousse delivery?
Increased failure
Increased cephalohaematoma
Increased retinal haemorrhage
Increased maternal worry
Advantages of ventousse delivery?
Decreased Anaesthesia
Decreased vag trauma
Decreased perineal pain
Disadvantage of C section?
4x greater maternal mortality
Sepsis, haemorrhage, VTE, trauma etc etc
Indications for C section?
Previous CS Fetal distress Failure to progress to labour Breech Maternal request
