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Abnormal Labour Flashcards

1
Q

How many pregnancies are induced?

A

1 in 5

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2
Q

Why are inductions of pregnancy not ideal?

A

Less efficient and more painful, needs fetal monitoring, risk of hyperstimulation of the uterus

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3
Q

Why might a women be induced?

A

Diabetes, post dates, maternal health problem that required planing of delivery, fetal reasons such as growth concerns, pelvic pain, big babies

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4
Q

How is an induction carried out?

A

Instigate labour using artificial prostaglandins or using devices to ripen cervix, followed by an amniotomy

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5
Q

What occurs after an amniotomy?

A

IV OXYTOCIN is given to induce contractions

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6
Q

How is progress in labour assessed?

A

Abdo and vaginal examination

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7
Q

What can be measured in a maternal abdominal or vaginal examination ?

A

Cervical effacement
Cervical dilation
Descent of the fetal head through the maternal pelvis

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8
Q

When is labour classed as suboptimal?

A

<0.5 cm per hour in primigravid women

1cm per hour for parous women

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9
Q

What occurs if contractions are inadequate?

A

Fetal head will not descend and exert force on the cervix and the cervix will not dilate

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10
Q

How may we increase the strength and duration of contractions ?

A

By giving a synthetic oxytocin

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11
Q

What may obstructed labour result in?

A

Ruptured uterus

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12
Q

What is CPD?

A

Cephalopelvic Disproportion = the fetal head is in correct position for labour but is too large to negotiate the maternal pelvis to be born

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13
Q

How can a baby present?

A

Cephalic, Breech, Transverse or Oblique

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14
Q

What is malposition?

A

Fetal head being in an incorrect position for labour and relative CPD occurs

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15
Q

What may cause fetal distress?

A

Hyperstimulation of the uterus due to insufficient placental blood flow

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16
Q

How is fetal wellbeing monitored?

A

Intermittent auscultation of the fetal heart
Cardiotocography
Fetal blood sampling
Fetal ECG

17
Q

Where is a fetal blood sample taken from?

A

Scalp of baby

18
Q

What is the fetal blood sample used to measure?

A

pH and base excess

19
Q

When is labour not advisable?

A

Obstruction to birth canal
- Major placenta praevia, masses

Malpresentation
- transverse, shoulder, hand, breech

Medical conditions where labour would not be safe for woman

Specific previous labour complications
-prev. uterine rupture

Fetal conditions

20
Q

What instruments can aid delivery?

A

Foreceps or vacuum extractions

21
Q

How many deliveries are assisted?

A

15%

22
Q

When may a C-Section carried out?

A

Electively, to manage obstructed labour, fetal distress before the cervix is fully dilated

23
Q

What risks does a C-Section carry?

A

infection, bleeding, visceral injury and VTE

24
Q

How many births are C-Sectioned in the UK?

A

25%

25
Q

Name some postnatal problems

A

PPH, VTE, Sepsis, psychiatric disorders, pre-eclampsia

26
Q

What is a PPH?

A

Primary - blood loss >500ml within 24 hours of delivery

Secondary - blood loss> 500ml from 24 hours post partum to 6 weeks

27
Q

What is lochia?

A

A period like bleed 3-4 weeks postnatal

28
Q

What is the link between pregnancy and hypercoaguability?

A

During pregnancy and immediate post partum, women are hypercoagulable. 6-10X more likely to develop a VTE

29
Q

What are the signs of VTE?

A

Unilateral leg swelling +/- pain & women complaining of SOB/Chest pain

Sometimes, unexplained tachycardia is only sign

30
Q

What can increase risk for VTE in pregnancy?

A

Spinal anaesthetic and C Section

31
Q

What are the investigations for VTE in pregnancy?

A

ECG, Leg Doppler, CXR +/- VQscan/ CTPA

32
Q

What is treatment forVTE?

A

LMWH

Reproduction (17 decks)

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