Caesarean Section, Foetal Monitoring in Labour and Induction of Labour Flashcards
Two types of Caesarean section?
Lower uterine segment incision- most common
Classical
When may a classical caesarean be undertaken rather than a lower uterine segment incision?
Very premature foetus
Very rapid delivery required
Indications for caesarean section?
Foetal distress
Failure to progress in labour
Failed induction of labour
Malpresentation
Severe pre-eclampsia
Placenta praevia
Twin pregnancy with non-cephalic presenting twin
Repeat caesarean section
What are the four categories of C-section?
Emergency
Urgent
Scheduled
Elective
How quickly should an emergency C-section take place?
Within 30mins
How quickly should an urgent C-section take place?
Within 90mins
Potential complications of a C-section?
Injury to surrounds structures- bladder or ureters
Haemorrhage
DVTs
Infection
To minimise risk of complications in a C-section, what is given to the mother?
Prophylactic antibiotics
Low molecular weight heparin
Under which type of anaesthetic is a C-section typically carried out?
Regional anaesthesia
What is done to all women having a C-section to protect the bladder?
All women are catheterized
What are some of the long term increased risks on future pregnancies because of C-section?
Placenta praevia or accreta
Antepartum stillbirth
Uterine rupture
Post-operative adhesions => subfertility
Acute foetal bradycardia has been noted on CTG. Conservative measures have not led to an improvement in foetal heart rate. What is the most appropriate management option?
A. Category I Caesarean Section
B. Category II Caesarean Section
C. Category III Caesarean Section
D. Category IV Caesarean Section
E. Induction of labour
A- Category I Caesarean Section
->this is because there is significant foetal compromise
What does foetal monitoring in labour do?
Assesses foetal wellbeing and allows for the detection of foetal distress (hypoxia)
In low risk labours, how is foetal monitoring carried out?
Intermittent auscultation
In high risk labours, how is foetal monitoring carried out?
Cardiotocography
->aka electronic foetal monitoring