Abnormal Labour Flashcards
What is the normal position of the vertex at the pelvic inlet?
Occipitotransverse
What is the normal position of the vertex at the pelvic outlet?
Occipitoanterior
How often should you perform a PV exam to assess progress during labour?
Every 4 hours
What is the name of the record that shows fetal HR, amniotic fluid, cervix dilation, descent, contractions, urinalysis and medications during labour?
Partogram
What is an abnormal fetal HR during labour
Less than 100
More than 180
How often should fetal HR be assessed during stage 1 of labour?
Every 15 minutes + after a contraction
NOT SURE IF THIS IS TRUE??
How often should fetal HR be assessed during stage 2 of labour?
Every 5min + after a contraction
What complication of IOL can prevent the progression of labour?
Hyperstimulation
Give examples of malpositions
Occipito-posterior
R / L occipito-transverse
What lie is normal? Which lies are malpresentation?
Normal longitudinal
Malpresentation transverse and oblique
What signifies failure to progress in stage 1 of labour?
Less than 2 cm dilated in 4 hours
What shape of pelvis is a risk factor for failure to progress?
Android
What signifies failure to progress in stage 2 of labour in a prim mother? And what if they’ve had an epidural?
Longer than 2 hours
Longer than 3 hours if had epidural
What signifies failure to progress in stage 2 of labour if this isn’t the mother’s birth?
Longer than 1 hour
What is the active Mx of failure to progress in labour for a women with week contractions? And when is this contraindicated?
Syntocinon
CI malposition
Molding, anuria, haematuria, and vulval edema are all signs of what in labour?
Obstruction eg. breech
In shoulder _____ the _____ shoulder is stuck under the ______
In shoulder DYSTOCIA the ANTERIOR shoulder is stuck under the PUBIC SYMPHYSIS
What is the Mx of cord prolapse?
Emergency C-section
Give 6 examples of pain Mx in labour
TENS Entonox Paracetamol Water bath IM diamorphine Regional anaesthetic
What are the main risks of an epidural?
Prolongs stage 2 of labour
Hypotension
Retention
(Also HA, sore back, others)
What are the 2 incision options in a ceaserean?
Lower segment and abdominal
What are the 2 methods of operative vaginal delivery
Forceps and ventouse
How would fetal distress present?
Fetal hypoxia
Meconium
Abnormal fetal HR
What investigation should be done if there are signs of fetal distress e.g. meconium?
Fetal blood sampling
CTG
