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3MB Reproduction (My version) > Abnormal Labour > Flashcards

Abnormal Labour Flashcards

1
Q

List factors that determine labour as abnormal

A 
Too early
Too late
Too painful
Too long
Foetal distress
Intervention required (operative)
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2
Q

What causes transient hypoxia in a baby during labour?

A

Uterine contractions (interrupt placental blood supply)

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3
Q

List options for providing analgesia during labour

A 
Support, massage/relaxation techniques
Paracetamol
Entonox (laughing gas)
TENS
Water immersion
IM diamorphine
IV remifentanil
Epidural anaesthesia
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4
Q

Epidural anaesthesia impairs uterine activity. True/False?

A

False

May inhibit progress during stage 2 labour, however

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5
Q

What vertebral level is the epidural anaesthetic injected into?

A

L3/L4 space

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6
Q

List potential complications of epidural anaesthesia

A 
Hypotension
Dural puncture
Headache
Backache
Atonic bladder
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7
Q

What counts as delay in stage 1 labour?

A

Nulliparous woman: less than 2cm dilation in 4 hours

Parous woman: less than 2cm dilation in 4 hours OR slowing in progress

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8
Q

What are the 3 P’s that affect progression of labour?

A

Power (inadequate contractions)
Passage (shape/state of pelvis)
Passenger (big baby, malposition)

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9
Q

Going down the pelvis, the transverse diameter increases/decreases and the anteroposterior diameter increases/decreases

A

Going down the pelvis, the transverse diameter decreases and the anteroposterior diameter increases

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10
Q

What is a partogram?

A

Graphical representation of the progression of labour

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11
Q

What is assessed on a partogram?

A 
Foetal heart rate
Amniotic fluid
Cervical dilation
Descent
Contractions
Obstruction (moulding/caput)
Maternal vital signs
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12
Q

How often is the foetal heart auscultated during labour?

A

Stage 1: during + after a contraction/every 15 mins

Stage 2: every 5-10 mins

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13
Q

Meconium (foetal stool) can be a sign of what?

A

Foetal distress

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14
Q

What is a CTG used for?

A

Assess foetal heart

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15
Q

You can only assess frequency of contractions on a CTG, not strength. True/False?

A

True

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16
Q

What is a normal foetal heart rate?

A

110-165 bpm

17
Q

What 4 features are assessed on a CTG?

What is the mnemonic for remembering this?

A 
Heart rate, variability, accelerations, decelerations
Mnemonic:
Determine
Risk
Contractions
Baseline
R
Ate
Variability
Accelerations
Decelerations
Overall impression
18
Q

Outline management of foetal distress in labour

A 
Change maternal position
IV fluids
Stop syntocinon
Consider tocolysis
Foetal blood sampling (hypoxia)
Operative delivery
19
Q

What is a normal pH to obtain upon foetal blood sampling?

A

pH greater than 7.25

20
Q

What are the main indications for cesarean section?

A 
Previous CS
Foetal distress
Failure to progress in labour
Breech presentation
Maternal request

3MB Reproduction (My version) (32 decks)

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