Abnormal Labour and Postpartum Care Flashcards
What are the indications for induction of labour?
Diabetes
Post dates (term +7)
Maternal health problem that necessitates planned delivery
Foetal growth concerns
How is labour induced?
Medications
Artificial rupture of membranes
What is the Bishop’s score?
Cervical ripening
What is used to ripen the cervix?
Vaginal prostaglandin pessaries
What is the process for induction once the cervix has dilated and effaced?
Amniotomy
What is used to achieve contractions when labour is induced?
IV oxytocin
What are the reasons for inadequate progress being made with labour?
Cephalopelvic disproportion Malposition Malpresentation Inadequate uterine activity Foetal distress
How is progress in labour evaluated?
Cervical effacement
Cervical dilatation
Descent of the foetal head through the maternal pelvis
What is cephalopelvic disproportion?
Foetal head is in the correct position for labour but is too large to negotiate the maternal pelvis
What can happen to the foetus with cephalopelvic disproportion?
Head is compressed, caput and moulding develop
How is foetal wellbeing determined during labour?
Intermittent auscultation of foetal heart
Cardiotocography
Foetal blood sampling
Foetal ECG
When would a C section be indicated in an abnormal labour?
Obstructed labour or foetal distress before cervix is fully dilated
What are the 3rd stage complications of labour?
Retained placenta
Post partum haemorrhage
Tears
What are the main causes of post partum haemorrhage?
Uterine atony
Traumatic tears to perineum/vagina/cervix
Retained tissue/placenta
Coagulopathy
What are the “4 T’s” associated with post partum haemorrhage?
Tone
Trauma
Tissue
Thrombin
