Abnormal Labour Flashcards
What is an induction of labour?
What is an amniotomy?
An attempt is made to instigate labour artificially using medications and/or devices.
A procedure carried out to burst the amniotic sac
Why are all labours not induced?
What is key to monitor during a induced labour?
Induced labours are less efficient and more painful.
In some cases it may lead to uterine hyperstimulation a disease where contractions are more sustained and more frequent.
Why would labour be induced
Diabetic mother
Term +7 days
maternal health problems
Fetal reasons e.g. growth concerns
What is the bishops score?
What score suggest san amniotomy should be performed
Explain the various components of the bishop score
a score used to measure if induction will be successful
7 or above
How do you induce contractions
What rate of contractions is aimed for?
What summarises when labour should not be induced and instead a c-section opted for
IV oxytocin
4-5 contractions every 10 minues
Power, Passage, Passenger
What is meant by the issues with power dueing labour?
Strong and co-ordinated uterine contractions are neede for the cervi to open and dilate.
This may be due to inadequate uterine contractions, dytocia
What is menat with problems with the passage during labour?
If the pelvis is not arranged properly or there is problems with the birth canal then the child may not come out properly
This can be due to Cephalopelvic disproportion, major placneta praevia, masses.
What is meant by problems with the passenger during labour?
Give some examples of problems with passenger
If there are problems with the baby itself then inducing laour may notbe the correct course of action
This can be due to a large baby, malposition,malpresentation, fetal stress
When are ceaserian sections essential?
What are the benefits and risks?
What percentage of UK woman have them?
During obstructed labour of fetal distress
Lower risk of perineal injury,
Increased risk of infecion, bleeding, visceral injury and VTE
25%
What is a post partum heamorrhage?
What treatment is given?
A complication of labour in which the woman loses excessive amounts of blood within 24 hours of labour
Primary- Fluids are pushed over 500ml of blood lost, Secondary- blood tranfsuions are given after 2L of blood lost
What causes post partum heamorrhage?
The four T’s:
abnormal uterine Tone
Trauma
Tissue injury
Thrombin
When does the midwife visit for the post delivery check?
What do they check for?
9-10 days
Signs of abnormal bleeding or infection
What do all woman recieve 6 weeks after delivery?
What is this to assess?
A post natal check at the GP
Issues with infant feeding, problems bonding, social and financial issues
Why are pregnant woman 6-10x more liely to develop a thromboembolism?
How is VTE picked up?
Pregnancy and postpartum are hypercoaguble states. More likely to develop thromboembolism (DVT or PE)
Using a high quakity risk assesment and giving thromboprophylaxis to those who are at risk
Typical signs are shortness of breath, chest pain, tachycardia. MAY PRESENT ATYPICALLY
How do you asess if someone has a venous thromboembolsim?
What is the treatent of a venous thromboembolism?
D dimers are unreliable! Use ECG, dopplers, CXR, V/Q scan- ventilation should be nromal, perfusion should be reduced.
Treat with low molecular weight heparin, warfarin is teratogenic
What is the leading cause of death in maternal woman in Britain?
How is it investigated?
How is it treated?
Sepsis. may present atypically
Blood cultures, MSSU, wound swabs, genital swabs (LVS)
When do most eclamptic seizures occur?
What kills 25% of woman between 6 weeks and a year post delivery
Post natally
Mental health problems. 1 in 7 of those died from suicide
What are the signs of postnatal depression?
How should it be investigated?
Who is at increased risk od post natal depression?
Classic depressive symptoms, can develop from baby blues or start sometime later
Asess mothers fucntioning,bonding with baby. Usually requires treatment
Woman with personal or family history of affective disorders
What is puerperal pyschosis?
How is it treated?
In which group is it mroe common?
Rare but serious illness of the postnatal period
With inpatient phychiatric care, woman can be a danger to themselves and their babies
Personal or ffamily history of affective disorders, bipolar disorders or psychosis
