Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Abnormal Labour > Flashcards

Abnormal Labour Flashcards

1
Q

What are the boundaries of the vertex of the foetal skull?

A

Anterior and posterior fontanelles and the parietal eminences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does malpresentation refer to?

A

Non-vertex birth position = breech, shoulder/arm, transverse, face brow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are two examples of malposition?

A

Occipito-posterior and occipito-transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What gestation would be referred to as preterm?

A

<37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What gestation would be referred to as post-term?

A

> 42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the types of breech presentation?

A

Complete, footling and frank

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the complete breech position?

A

Legs folded with feet at the level of the baby’s bottom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the footling breech position?

A

One or both feet point down so legs would emerge first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the frank breech position?

A

Legs point up with feet by baby’s head so bottom emerges first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can abnormal labour refer to?

A

Too early or too late, too painful, too long or too quick, foetal distress or wrong part presenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some analgesic options for during an abnormal labour?

A

Support and massage/relaxation techniques
Inhalation agents (entonox) or IM opiates
TENS = T10-L1, S2-4
IV remifentanil PCA or epidural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How effective is an epidural anaesthetic?

A

Complete pain relief on 95% and doesn’t impair uterine activity = may inhibit progress during stage 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs are given during an epidural anaesthetic?

A

Levobupivacaine +/- opiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the complications of an epidural anaesthetic?

A

Hypotension (20%), dural puncture (1%), headache, high block, atonic bladder (40%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risks associated with an obstructed labour?

A

Sepsis, uterine rupture, obstructed AKI, postpartum haemorrhage, fistula formation, foetal asphyxia, neonatal sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is progress of labour assessed?

A

Cervical dilation, descent of presenting part, signs of obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some signs of obstructed labour?

A

Moulding, caput, anuria, haematuria, vulval oedema

18
Q

When would you suspect delay in stage 1 of labour?

A

<2cm dilation in 4hrs if nulliparous

<2cm dilation in 4hrs or slowing in progress if parous

19
Q

What are the 3P’s used to assess failure to progress?

A 
Powers = inadequate contractions (frequency/strength)
Passage = short stature, trauma, shape 
Passenger = big baby, malposition (relative cephalo-pelvic disproportion)
20
Q

What is a partogram?

A

Graphic representation of labour progress = commenced as soon as in established labour

21
Q

What are some of the areas assessed in a partogram?

A

Maternal observations (e.g BP), descent, cervical dilation, foetal heart, amniotic fluid, contractions

22
Q

What can be used to carry out intraoartum foetal assessment?

A

Doppler auscultation of foetal heart, electronic foetal monitoring (CTG), colour of amniotic fluid

23
Q

How often should doppler auscultation of the foetal heart be done during labour?

A

Stage 1 = during and after every a contraction, every 15 minutes
Stage 2 = at least every 5 mins, during and after a contraction for 1 min

24
Q

How often should maternal pulse be checked during the second stage of labour?

A

At least every 15 mins

25
Q

What are the risk factors for foetal hypoxia?

A 
Small foetus or preterm/post date 
Antepartum haemorrhage or sepsis (temp >38C)
Hypertension or pre-eclampsia 
Diabetes, meconium or PROM >24hr
Epidural anaesthetic or VBAC
Induction or augmentation of labour
26
Q

What are the acute causes of foetal distress?

A

Abruption, vasa praevia, cord prolapse, uterine rupture, foeto-maternal haemorrhage, uterine hyperstimulation, regional anaesthesia

27
Q

What are the chronic causes of foetal distress?

A

Placental insufficiency, foetal anaemia

28
Q

What is a CTG?

A

Recording of contractions = decelerations, accelerations, variability, baseline heart rate, duration and quality of recording

29
Q

What four features should be documented during a CTG assessment?

A

Baseline foetal heart rate, baseline variability, presence or absence of decelerations, presence of accelerations

30
Q

What can the results of a CTG be classed as?

A

Normal, suspicious or pathological

31
Q

How do you interpret a CTG?

A

Determine risk = contractions, baseline, rate, variability, accelerations, decelerations, overall impression

32
Q

What is the appearance of hypoxia on CTG?

A

Loss of accelerations, repetitive deeper and wider decelerations, rising foetal baseline heart rate, loss of variability

33
Q

What is the management of foetal distress?

A

Change maternal positions and maternal assessment
IV fluids, scalp stimulation and stop syntocinon
Consider tocolysis = terbutaline 250mg
Foetal blood sampling and operative delivery

34
Q

How does scalp pH from foetal blood sampling alter management?

A

pH >7.25 = normal result, no action needed
pH 7.2-7.25 = borderline, repeat sample in 30mins
pH <7.2 = abnormal result, deliver foetus

35
Q

What are the standard indications for operative vaginal delivery?

A

Delay = failure to progress to stage 2

Foetal distress

36
Q

What are the special indications for operative vaginal delivery?

A

Maternal cardiac disease, severe pre-eclampsia or eclampsia, intrapartum haemorrhage, stage 2 umbilical cord prolapse

37
Q

What are the benefits of using the ventouse method of delivery?

A

Vacuum suction so reduces analgesia, vaginal trauma and perineal pain

38
Q

What are the disadvantages of the ventouse delivery method?

A

Increased failure, cephalohaematoma, retinal haemorrhage, maternal worry

39
Q

What are the indications for doing a C-section?

A

Previous C-section, foetal distress, failure for labour to progress, breech, maternal request

40
Q

By how much does a C-section increase risk of maternal death?

A

Increases maternal mortality by 4x

41
Q

What are some morbidities associated with C-section?

A

Sepsis, haemorrhage, VTE, trauma, TTN, subfertility, regret, complications for future pregnancy

Reproduction (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions