abnormal labour Flashcards
pre labour rupture of membranes defined as ?
rupture of membranes before 37 weeks
cause of pre labour ROM?
lower genital tract infections
management of pre labour ROM?
admission for monitoring
if pre term –> steroids
expectant mangement - allow 24 hours for labour
active management - induce labour
during the first stage of labour, how long is too long to reach 4cm dilation?
3-8 hours
what is primary arrest?
poor progress in active phase of stage 2 - less than 2 cm dilation after 4 hours
causes of failure to progress in second stage?
weak irregular contractions
cephalo pelvic disproportion
how long is too long in second stage of labour (delivery?)
prim with epidural - over 3 hours
prim without - over 2
multi with - over 2
multi without over 1
what are risk factors for breech presentation ?
multiple pregnancies, twins, congenital abnormalities, uterine abnormalities
re natal management of breech?
external cephalic version
what does external cephalic version carry risk of?
rhesus auto immunisatoin
how long should you leave metal distress before carrying out a c section ?
4-6 hours
what is management of mal position ?
usually vaginal operative
where does head need to be to perform operation vaginal?
station
how are breech babies usually delivered?
section
what colour should the liqor be?
clear
thick, green liquor?
meconium stained
what are two reasons for meconium stained liquor?
post term baby
fetal distress
excessive head moulding may result in ?
cranial birth injuries
if you augment labour with syntocinin what do you need to do?
start CTG
do you start CTG with meconium stained liquor?
yes
signs of fetal distress on CTG?
braycardia
late decelerations
loss of variability
during labour, how often should heart rate be assessed?
in stage 1 - every 15 mins
in stage 2 at every contraction/5 mins
if you do a metal blood sample from the scalp and pH is 7.2 - what do you do?
acidotic. delivery required immediately
management of fetal distress?
sit mother up
IV fluids
