Birth Flashcards

1
Q

Widest landmark of faetal head?

A

“the bi-parietal landmark”

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2
Q

“the more flexed the fetal head, the ____________”

A

"”the more flexed the fetal head, the smaller the diameter of the presenting part”

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3
Q

What are the 3 P’s for labour?

A

Passage: pelvis Passenger: size and position of baby Power: strength of uterine contractions

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4
Q

How do the waters usually break? What else can happen?

A

Spontaneous Rupture of Membranes (SROM) However they can break before labour commences (pre-labour Rupture of membranes) or even artificially (ARM).

Occassionally a baby is born with the membranes still intact: “encaul”

PPROM: preterm prelabour rupture of membranes***

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5
Q

What are the 3 phases of Stage 1 of labour?

A

Phase 1: Latent Phase. Cervical effacement and ~3cm dilitation. *In nulliparous women this can last 10-12 hrs*

Phase 2: Accelatory. ~1cm/hour dilitation with increased uterine contractions and the head descends.

Phase 3: Transition. onset of expulsion of the head of the baby

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6
Q

Describe Stage 2 of Labour

A

From full dilitation to the birth of the baby.

Can be latent (esp if epidural used)

Active is with mother actively pushing out

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7
Q

Describe Stage 3 of Labour

A

From birth of baby until birth of the placenta.

Uterine muscles contract to stop blood loss once the palcenta has seperated, and it is usually expelled <60 minutes.

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8
Q

Natural stage 3 of labour versus medically controlled?

A

Natural: Sometimes higher risk of blood loss

Medically controlled: With Oxytocin, clamping of the cord and using controlled cord traction Increased side effects of N+V+ HTN

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9
Q

the baby is said to be engaged when …..

A

The point of widest diameter of the presenting part (usually the head unless the baby is in breech) is past the pelvic inlet

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10
Q

What is IOL and how many women require it?

A

Induction of Labour is common and required by 15-20% of women

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11
Q

What scoring system is used to assess the need for IOL?

A

The Bishop score:

assesses the readiness/’ripeness’ of the cervix and the dose of medication required.

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12
Q

On the Bishop Scoring System, what does a low score vs a high score indicate for treatment?

A

Low Score: longer induction. Vaginal prostagladin gel or balloon catheter used.

High Score >5: Now a ARM (Artificial Rupture of Membranes) is usually done, so the IV oxytocin infusion (syntocin) can be used to start or increase contractions

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13
Q

ideal labour contractions shoudl be what?

A

Strong, lasting ~60seconds, around 3/4x per ten minutes

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14
Q

Reasons for poor uterine contractions

A
  • Fatigue
  • Dehydration
  • exhaustion
  • Pain and fear
  • Idiopathic
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15
Q

Support for patients with poor uterine contractions

A
  • IV fluids
  • Amniotomy (ARM with Amniohook)
  • Oxytocin
  • Pain relief
  • Support
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16
Q

Should Oxytocin be used to help multiparous women with utetrine contraction problems

A

**Caution**

unlikely to be due to inadequate uterine activity alone.

When using oxytocin ensure membranes are ruptured, give continuous monitoring and perform regular review.

17
Q

What will cause accelerations on CTG

A

Contractions will block fetal blood flow, causing an acceleration of the heart rate.

Fetal movement can also cause accelerations.

18
Q

What is the concern surrounding a decceleration on CTG?

A

Deceleration of the fetal HR during or after a contraction may indicate fetal stress.

A compromised fetus is more likely to get stressed and not cope, ultimately becoming acidotic and hypoxic

19
Q

What are the causes of the differing types of decelerations

A

Early decelerations: Normal in the first stageof labour, indicatees head contractions not hypoxia.

Late Decelerations: associated with decreased uterine blood flow during contractions, can indicate fetal hypoxia

Variable Decelerations: Due to cord compression, can lead to fetal hypoxia

20
Q

What are all the things we should be looking at within a CTG (anagram)

A

DR C BRAVADO

DR - Define Risk

C - Contractions

BR - Baseline rate

A - Accelerations

VA - VAriability

D - Decelerations

O - Overall impression

21
Q

Normal HR and variability that can be seen on CTG

A

Baseline- 110-160 bpm

Variability- 5-25 bpm

Accelerations- rise 15bpm for 15secs

22
Q
A