abnormal labour

Question 1

pre labour rupture of membranes defined as ?

Answer 1

rupture of membranes before 37 weeks

Question 2

cause of pre labour ROM?

Answer 2

lower genital tract infections

Question 3

management of pre labour ROM?

Answer 3

admission for monitoring
if pre term –> steroids
expectant mangement - allow 24 hours for labour
active management - induce labour

Question 4

during the first stage of labour, how long is too long to reach 4cm dilation?

Answer 4

3-8 hours

Question 5

what is primary arrest?

Answer 5

poor progress in active phase of stage 2 - less than 2 cm dilation after 4 hours

Question 6

causes of failure to progress in second stage?

Answer 6

weak irregular contractions

cephalo pelvic disproportion

Question 7

how long is too long in second stage of labour (delivery?)

Answer 7

prim with epidural - over 3 hours
prim without - over 2
multi with - over 2
multi without over 1

Question 8

what are risk factors for breech presentation ?

Answer 8

multiple pregnancies, twins, congenital abnormalities, uterine abnormalities

Question 9

re natal management of breech?

Answer 9

external cephalic version

Question 10

what does external cephalic version carry risk of?

Answer 10

rhesus auto immunisatoin

Question 11

how long should you leave metal distress before carrying out a c section ?

Answer 11

4-6 hours

Question 12

what is management of mal position ?

Answer 12

usually vaginal operative

Question 13

where does head need to be to perform operation vaginal?

Answer 13

station

Question 14

how are breech babies usually delivered?

Answer 14

section

Question 15

what colour should the liqor be?

Answer 15

clear

Question 16

thick, green liquor?

Answer 16

meconium stained

Question 17

what are two reasons for meconium stained liquor?

Answer 17

post term baby

fetal distress

Question 18

excessive head moulding may result in ?

Answer 18

cranial birth injuries

Question 19

if you augment labour with syntocinin what do you need to do?

Answer 19

start CTG

Question 20

do you start CTG with meconium stained liquor?

Answer 20

yes

Question 21

signs of fetal distress on CTG?

Answer 21

braycardia
late decelerations
loss of variability

Question 22

during labour, how often should heart rate be assessed?

Answer 22

in stage 1 - every 15 mins

in stage 2 at every contraction/5 mins

Question 23

if you do a metal blood sample from the scalp and pH is 7.2 - what do you do?

Answer 23

acidotic. delivery required immediately

Question 24

management of fetal distress?

Answer 24

sit mother up

IV fluids