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3 Reproduction and Sexual Health > Abnormal Labour and Obstetric Emergencies > Flashcards

Abnormal Labour and Obstetric Emergencies Flashcards

1
Q

how many women achieve a normal SVD?

A

60%

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2
Q

how many women need a forceps delivery?

A

15%

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3
Q

define malpresentation?

A

non-vertex

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4
Q

posterior fontanelle is shaped like…

A

a triangle

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5
Q

anterior fontanelle is shaped like…

A

a diamond

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6
Q

malposition is defined as…

A

OP or OT

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7
Q

pre-term delivery is defined as

A

37

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8
Q

post-term delivery is defined as >_ weeks

A

42

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9
Q

risk of stillbirth increases at >_ weeks

A

38

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10
Q

Tx cord prolapse

A

category 1 CS (within 30 mins)

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11
Q

describe a footling breech?

A

one or both feet point down

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12
Q

describe a frank breech?

A

legs point up with feet at baby’s head so bottom comes first

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13
Q

describe a complete breech

A

legs folded with feet at level of baby’s bottom

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14
Q

when would a malpresentation prompt a definite CS delivery?

A

active labour

membranes ruptured

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15
Q

what malpresentation of the face can still undergo a vaginal delivery? why?

A

mentoanterior

can still flex chin to chest

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16
Q

anesthesia used in CS? what anaesthetic is used in emergencies

A

spinal -15/20 mins

general - for emergencies

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17
Q

risks for obstructed labour

A 
sepsis
uterine rupture
AKI (obstruction)
PPH
fistula
fetal asphyxia
neonatal sepsis
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18
Q

define obstructed labour

A

even though the uterus is contracting normally, the baby does not exit the pelvis during childbirth due to being physically blocked.

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19
Q

how do you assess progress in labour?

A

cervical dilatation via VE

descent of presenting part

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20
Q

signs of obstruction?

A 
moulding
caput (swollen fontanelles)
anuria
haematuria
vulval oedema
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21
Q

failure to progress is defined as

A

failure of the cervix to dilate by 2cm in 4hrs

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22
Q

how many contractions do you want in labour per 10 mins?

A

3-5 in 10 mins

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23
Q

what problems with the baby can cause failure to progress?

A

big baby

malposition

24
Q

components of intra-partum fetal assessment?

A

doppler auscultation of fetal heart every 15 mins
colour of AF
CTG

25
Q

why is fetal HR checked for 1 whole min after a contraction?

A

late decelerations to check for hypoxia

26
Q

risk factors for fetal hypoxia?

A 
SGA
pre/post term
APH
hypertensive problems 
diabetes
meconium
epidural
sepsis
IOL
27
Q

a temp over _ degrees makes you worry about sepsis

A

38

28
Q

acute causes of fetal distress

A 
uterine hyperstimulation eg syntocinon
PA
vasa praevia
cord prolapse
uterine prolapse
feto-maternal haemorrhage
regional anaesthesia
29
Q

chronic causes of fetal distress

A

placental insufficiency

fetal anaemia

30
Q

normal FH rate?

A

110-150bpm

31
Q

normal variability

A

5-25bpm

32
Q

how should you deliver a baby in fetal distress?

A

whatever way is quickest

33
Q

early decelerations are normal T or F

A

T

34
Q

why does epidural anaesthesia carry a risk of fetal distress?

A

vasodilatation underperfuses babys placenta

35
Q

define the DR C BRAVADO method of reading a CTG

A 
Determine Risk
Contractions
Baseline RAte
Variability
Accelerations
Decerations
Overall impression
36
Q

Tx of fetal distress

A 
change maternal position
IV fluids
stop syntocinon
scalp stimulation
vitals
abdo exam/VE
FBS
operative delivery
37
Q

what is tocolysis? give an example of a tocolytic drug

A

medication that relaxes the uterus

terbutaline

38
Q

when would you do fetal blood sampling?

A

if cervix >4cm dilated

not sure about CTG

39
Q

Ix fetal distress

A
  1. CTG, VE, vitals, abdo exam

2. FBS

40
Q

scalp pH under ___ on FBS is concerning

A

7.2

41
Q

standard indications for assisted vaginal delivery?

A

delay

fetal distress

42
Q

special indications for assisted vaginal delivery?

A

maternal cardiac disease
severe PET
IPH
cord prolapse stage 2

43
Q

duration of stage 2 for prims without epidural? with epidural?

A

2h

3h

44
Q

duration of stage 2 for multiparous women without epidural? with epidural?

A

1h

2h

45
Q

what is a ventouse delivery?

A

vaginal delivery using suction

46
Q

ventouse delivery is less safe than forceps or CS T or F

A

F

47
Q

contraindications to FBS?

A

anaemic babies
low platelets
high bleeding risk

48
Q

main indications for CS?

A 
previous CS
fetal distress
failure to progress in labour
breech presentation
maternal request
49
Q

main complications of CS?

A 
sepsis
haemorrhage
VTE
trauma
hysterectomy if bleeding badly
50
Q

what is shoulder dystocia

A

ant shoulder stuck under symphysis pubis which causes hypoxia

51
Q

how long do you have to deliver a baby who is hypoxic from shoulder dystocia?

A

7

52
Q

cause of uterine inversion?

A

iatrogenic from pulling on cord too hard

53
Q

main causes of maternal collapse?

A

4Hs and 4T’s PLUS:
amniotic fluid embolism
pre-eclampsia

54
Q

how can you resolve supine hypotension in a pregnant woman?

A

turn woman into left lateral position

55
Q

pathophysiology of aortocaval compression

A

lying supine can compress IV and aorta causing reduced venous return

56
Q

how long after performing CPR on a collapsed pregnant woman should you attempt delivery?

A

4 mins

3 Reproduction and Sexual Health (51 decks)

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