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Reproductive System > Abnormal Labour and Postpartum Care > Flashcards

Abnormal Labour and Postpartum Care Flashcards

1
Q

What are the disadvantages of inducing labour?

A

Less efficient, more painful

Risk of uterine “hyperstimulation” with prostaglandin/oxytocin induction

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2
Q

Indications for induction

A

Diabetes
Post dates – Term + 7 days
Maternal health problem that necessitates planning of delivery e.g. on treatment for DVT
Fetal reasons e.g. growth concerns, oligohydramnios

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3
Q

Oligohydramnios

A

Deficiency of amniotic fluid

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4
Q

What is induction of labour?

A

When an attempt is made to instigate labour artificially using medications and/or devices to “ripen cervix” followed usually by artificial rupture of membranes

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5
Q

How is the cervix clinically assessed?

A

Bishop’s score

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6
Q

Is a higher or lower Bishop’s score indicative of induction?

A

The higher the score, the more progressive change there is in the cervix and indicates that induction is likely to be successful

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7
Q

How can a cervix be ripened for a lower Bishop’s score?

A

Vaginal prostaglandin pessaries / Cook Balloon

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8
Q

What is an amniotomy?

A

The artificial rupture of the foetal membranes (“waters”) usually using a sharp device

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9
Q

What are the stages of induction?

A

Cervical ripening
Amniotomy
IV oxytocin

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10
Q

What are the types of causes of problems in labour?

A

Passge
Powers
Passenger

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11
Q

What is determined by an evaluation of progress in labour (by a combination or abdominal and vaginal examinations)?

A

Cervical effacement
Cervical dilatation
Descent of the fetal head through the maternal pelvis

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12
Q

What is suboptimal progress of labour for primigravid women? Parous women?

A

Less than 0.5cm per hour for primigravid women

Less than 1cm per hour for parous women

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13
Q

What will happen if contractions are inadequate?

A

The foetal head will not descend and exert force on the cervix and the cervix will not dilate

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14
Q

How can the strength and duration of contractions be increased?

A

Giving synthetic IV oxytocin

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15
Q

Whta could an obstructed labour lead to?

A

Ruptured uterus

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16
Q

Cephalopelvic disproportion (CPD)

A

Foetal head is in the correct position for labour but is too large to negotiate the maternal pelvis

17
Q

What is malposition?

A

Involves the foetal head being in an incorrect position for labour and “relative” CPD occurs
Occipito-posterior/transverse

18
Q

Malpresentation

A 
Longitudinal lie (breech presentation)
Transverse lie (shoulder presentation)
19
Q

How is foetal wellbeing in labour determined?

A

Intermittent auscultation of the fetal heart
Cardiotocography
Fetal blood sampling
Fetal ECG

20
Q

How does too many contractions result in foetal distress?

A

Insufficient placental blood flow

21
Q

When is foetal blood sampling used?

A

When abnormal CTG

22
Q

What can pH show about the baby?

A

Likely hypoxaemia

23
Q

When is labour not advised?

A

Obstruction to birth canal
Medical conditions where labour would not be safe for woman
Specific previous labour complications
Fetal conditions

24
Q

What are some obstructions to the birth canal?

A

Major placenta praevia

Masses

25
Q

Specific previous labour complications

A

Previous uterine rupture

26
Q

What risks does C section carry?

A

Infection
Bleeding
Visceral injury
VTE

27
Q

What is the advantage of C section?

A

Reduced risk of perineal injury compared to vaginal birth

28
Q

3rd stage complications

A

Retained placenta

Post partum haemorrhage

29
Q

Post natal problems

A 
Post partum haemorrhage
Venous thromboembolism
Sepsis
Psychiatric disorders of the puerperium
Pre-eclampsia
30
Q

What are the 4 T’s of PPH?

A

Tone
Trauma
Tissue
Thrombin

31
Q

What is pre-eclampsia?

A

A disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction. Onset may be before, during, or after delivery

32
Q

What is eclampsia?

A

The onset of seizures (convulsions) in a woman with pre-eclampsia

Reproductive System (24 decks)

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