abnormal labour and post partum care Flashcards
what are indications for induced labour ?
diabetes
post term + 7 days
maternal health problems that need delivery
fetal reasons - growth, oligohydramnios
what is Bishop’s score ?
used to assess how successful induced labour. will be
what is scores on Bishop’s score ?
dilatation cm - 0,1-2, 3-4, 5+ length of cervix cm - 3, 2, 1, 0 position - posterior, mid, anterior consistency - firm, medium, soft station cm - -3, -2, -1/0, 1/2
how is labour induced ?
vaginal prostaglandin pessaries used/ Cook balloon to open cervix
Bishop score 7+ favourable for amniotomy with amniohook
IV oxytocin to induce contractions, 4-5 contractions in 10 mins
what is the correct position for the head during labour ?
occipito-anterior
how do you assess fetal well-being in labour ?
intermittent auscultation of fetal heart
cardiotocography CTG
fetal blood sampling
fetal ECG
what are situations where labour is not advised ?
obstruction to birth canal - placenta praaevia, masses
malpresentation
medical conditions where labour is not safe
specific previous labour complications
fetal conditions
what are risks of caesarean section ?
infection
bleeding
visceral injury
VTE
what are common postnatal problems ?
post partum haemorrhage venous thromboembolism sepsis psychiatric disorder PET
what is primary postpartum haemorrhage ?
blood loss >500ml within 24 hours of delivery
what causes postpartum haemorrhage ?
4 Ts
Tone - uterine atonia
trauma
tissue - placenta left behind
thrombin - bleeding disorder
what is secondary post partum haemorrhage ?
blood loss >500 ml from 24 hours post partum to 6 weeks
what is the leading cause of maternal death in the uk ?
maternal sepsis
what is baby blues ?
affects women due to hormonal change around time of birth 1-3 days PN
does not affect functioning, no treatment
when do most eclamptic seizures occur ?
the postnatal period
