Antenatal Care and Labour Flashcards
What is a booking appointment?
By 10 weeks, first contact identifying risks, screen for illness and health promotion
Give 4 risk factors of pregnancy which should be identified at booking
- > 40 or <18 years
- Para 6+ or Para 0
- Extremes of BMI
- Low socio-economic status
Give 4 conditions which are screened for in a mother in the 1st trimester
- Anaemia
- Sickle cell disease
- Rubella
- HIV
- Syphilis
When and how is fatal Down syndrome screening carried out?
11-14 week on Nuchal translucency scan (this is not diagnostic)
From when in pregnancy can CVS be carried out?
11 weeks
From when in pregnancy can amniocentesis be carried out?
15 weeks
In non-invasive prenatal testing of maternal blood, which things can be determined?
Trisomies 13, 18 and 21
X/Y
When is the 2nd trimester of pregnancy?
12-20 weeks
When is a fetal anomaly scan carried out?
Between 18-22 weeks
When is the 3rd trimester?
20 weeks - term
Give 4 antenatal complications which should be picked up at antenatal appointments
- Polyhydramnios
- Oligohydramnios
- Pre-eclampsia
- Anaemia
- Gestational diabetes
Name 2 pro-labour factors
Oxytocin
Prostaglandins
Which score is used to assess cervical ripening?
Bishop’s score
How is labour diagnosed?
o Regular contractions and fully effaced cervix
OR
o Spontaneous ROM and regular uterine activity
How often should women in active labour be examined?
4 hours
What is the first stage of labour?
Onset of labour to full cervix dilation
What is the second stage of labour?
Full cervical dilation until the head is delivered
What is the third stage of labour?
From delivery of baby until expulsion of placenta and membranes
What is meant by station of presenting part?
Describes position of babies head, in cm above or below ischial spines, spines is station 0
Define caput
Oedema of scalp due to pressure of head against rim of cervix (+, ++ or +++)
Define moulding
Change in head shape during labour
What is a partogram?
Graphic recording of clinical findings and any relevant events. Maternal BP, HR, temp…
Define slow labour
Less than 2cm dilation in 4 hours due to inadequate uterine activity
Define malpresentation
When babies head is not presenting part e.g. breech
Define malposition
Abnormal position of vertex relative to maternal pelvis
Give 3 indications for induction of labour
- Maternal diabetes
- Twin pregnancy
- Pre-labour ROM
If Bishop’s <6 (unfavourable cervix) what is given to induce labour?
Prostaglandin gel/tablet into vagina
If Bishop’s score >6 (favourable cervix) what is done to induce labour?
ARM
Syntocinon
Give 4 pharmacological analgesics used in labour
o Entonox 50:50
o IM diamorphine
o Epidural/spinal
o GA
What is a 1st degree perineal tear?
Vaginal epithelium and vulval skin injury only
What is a 2nd degree perineal tear?
Injury to perineal muscles but not anal sphincter
What is a 3rd degree perineal tear?
Injury involving anal sphincter complex
What is a 4th degree perineal tear?
Involves anal sphincter couples and rectal mucosa
Give 3 indications for an episiotomy
- Rigid perineum preventing delivery
- Large tear imminent
- Instrumental deliveries
Define pre-term labour
Gestation less than 37 complete weeks
How can pre-term labour be managed?
IM betamethasone or dexamethasone over 24 hr to increase pulmonary surfactant produced by fetal type II pneumocytes
Define direct maternal death and its main cause
Death resulting from complications of pregnancy, interventions, omissions or incorrect treatment
Thrombosis and thromboembolism
Define indirect maternal death and its main cause
Deaths from previous/existing disease or disease developed during pregnancy not due to obstetric causes but aggravated by physiological effects of pregnancy
Heart disease
Define coincidental maternal death
Death from unrelated causes which happen to occur during pregnancy or 6 weeks PP
Define late maternal death
eath of a women from indirect or direct obstetric causes within more than 42 days after but less than 1 year of end of pregnancy
Which programme audits risk in obstetrics throughout the UK?
MBRRACE UK
