Abnormal Labour Flashcards
How many pregnancies are induced?
1 in 5
Why are inductions of pregnancy not ideal?
Less efficient and more painful, needs fetal monitoring, risk of hyperstimulation of the uterus
Why might a women be induced?
Diabetes, post dates, maternal health problem that required planing of delivery, fetal reasons such as growth concerns, pelvic pain, big babies
How is an induction carried out?
Instigate labour using artificial prostaglandins or using devices to ripen cervix, followed by an amniotomy
What occurs after an amniotomy?
IV OXYTOCIN is given to induce contractions
How is progress in labour assessed?
Abdo and vaginal examination
What can be measured in a maternal abdominal or vaginal examination ?
Cervical effacement
Cervical dilation
Descent of the fetal head through the maternal pelvis
When is labour classed as suboptimal?
<0.5 cm per hour in primigravid women
1cm per hour for parous women
What occurs if contractions are inadequate?
Fetal head will not descend and exert force on the cervix and the cervix will not dilate
How may we increase the strength and duration of contractions ?
By giving a synthetic oxytocin
What may obstructed labour result in?
Ruptured uterus
What is CPD?
Cephalopelvic Disproportion = the fetal head is in correct position for labour but is too large to negotiate the maternal pelvis to be born
How can a baby present?
Cephalic, Breech, Transverse or Oblique
What is malposition?
Fetal head being in an incorrect position for labour and relative CPD occurs
What may cause fetal distress?
Hyperstimulation of the uterus due to insufficient placental blood flow
How is fetal wellbeing monitored?
Intermittent auscultation of the fetal heart
Cardiotocography
Fetal blood sampling
Fetal ECG
Where is a fetal blood sample taken from?
Scalp of baby
What is the fetal blood sample used to measure?
pH and base excess
When is labour not advisable?
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
What instruments can aid delivery?
Foreceps or vacuum extractions
How many deliveries are assisted?
15%
When may a C-Section carried out?
Electively, to manage obstructed labour, fetal distress before the cervix is fully dilated
What risks does a C-Section carry?
infection, bleeding, visceral injury and VTE
How many births are C-Sectioned in the UK?
25%
