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MIDW 305 > CBL 9 - Breech > Flashcards

CBL 9 - Breech Flashcards

1
Q

What is the biggest risk of malpresentation?

A

Cord prolapse

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2
Q

What is the biggest risk of malpresentation?

A

Cord prolapse

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3
Q

What is malpresentation?

A

The part that is in the pelvis, ex. Breech, transverse

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4
Q

What is malposition?

A

How the head is positioned, ex OP

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5
Q

Factors associated with malpresentation? (6)

A
  • High order parity (pendulous abdomen)
  • Contracted pelvis
  • Malformations of uterus
  • Altered placentation
  • Extremes of amniotic fluid (poly or oligo)
  • PROM
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6
Q

Risks of malpresentation? (7)

A
  • Cord prolapse
  • Labour dystocia
  • Maternal trauma
  • Surgical/instrumental birth
  • PPH
  • Fetal morbidity
  • Perinatal mortality
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7
Q

What is the denominator of face presentation?

A

Mentum

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8
Q

Can mentum be born vag?

A

Yes, if in mentum anterior

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9
Q

Can brow be born vag?

A

No

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10
Q

Can shoulder be born vag?

A

No

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11
Q

What are some malpresentations in labour?(6)

A
  • Face,
  • brow,
  • breech,
  • shoulder,
  • compound cord
  • unstable lie
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12
Q

How common is breech?

A

3-4 %

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13
Q

What is the most feared outcome of vag breech birth?

A

Entrapment

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14
Q

What are the types of breech presentation?

A
  • Frank
  • complete
  • footling
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15
Q

What is frank breech?

A

Buttocks in pelvis with hips flexed, knees extended, feet toward had
Most favourable for breech vag birth

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16
Q

What is complete breech?

A

Fetal buttocks in pelvis with both hips and knees flexed.
Squatting, sitting cross legged

17
Q

What is footling breech?

A

Fetal hips are deflexed and both or one knee is extended resulting in both/one foot presenting.
Not favourable for vag birth
More likely for prolapsed cord and irregular dilating surface, fetal entrapment

18
Q
A
18
Q

Contraindications for ECV? (9)

A
  • C/S birth indicated
  • Antepartum hemorrhage in last week
  • Ab EFM
  • Major uterine anomly
  • Multiple pregnancy
  • Preclampsoa
  • Small for GA, ab dopplers
  • Oligo
  • Major fetal anomolies
19
Q

Success rate for ECV?

A

30 % nulips
58% multips

19
Q
A
20
Q

What should be done prior to an ECV?

A

Rh immunoglobulin if indicated
NST

21
Q

Complications of ECV? (5)

A

Short term FHR decel common complication post ECV

Less common:
* fracture of fetal leg bones,
* ROM,
* placental abruption,
* feto-maternal hemmorhage

21
Q

How does IFHB work?

A
  • Managed through Medavie Blue Cross (MBC)
  • It’s a (seemingly) simple online or mailed form to sign up
  • Works similarly to MSP
  • Once approved you submit through MBC’s online platform for reimbursement
    For people with refugee status
22
Q

Does IFHB apply to newborns?

A

No, they are citizens so have MSP

23
Q

What could Thalassemia look like on a CBC?

A

RBC N
Hb Low
MCV Low
MCH Low
Ferritin Normal high

24
Q

What kind of disorder is thalassemia?

A

Autosomal recessive

24
Q

Who more likely to be a carrier of thalassemia? (5)

A

Sub-Saharan African
Middle Eastern
Meditaranian
Indian
East/Southeast Asian

25
Q

What is Bart’s disease?

A

4 /4 thalassemia genes – hydrops incompatible with life

26
Q

What is the chance of 2 carriers of thalassemia having a babe with Bart’s disease?

A

25 %

27
Q

What is sickle cell disease?

A
  • Homozygous SS disease – autosomal recessive inherited disorder where hemoglobin S is produced instead of hemoglobin A. (1)
  • Red blood cells (RBCs) form a moon/sickle shape making them less able to bend to travel through blood vessels, are more adhesive and more likely to clump together (1)
28
Q
A
28
Q

Sickle cell disease most common?

A

Black African American, but also Mediterranean, India, Middle East, sub-Saharan Africa

29
Q

Sickle cell disease in pregnancy?

A

Maternal
* Raised metabolism (2)
* Higher hormones that raise risk of blood clots (2)
* Serious anemia (2)
* Increased pain crises (2)
* Increased risk of dying in pregnancy or postpartum (2)
* Higher risk of serious diseases caused by sickle cell disease (2)
* High blood pressure (2)
* Venous thromboembolism (2)
* Preeclampsia (2)
* UTIs (2)

Fetal
* Miscarriage (2)
* Preterm birth (2)
* Low birth weight (2)
* IUGR (2)
* Stillbirth (2)

30
Q

Sickle cell train in pregnancy?

A

Usually asymptomatic:
Genetic counselling, increase incidence of UTIs, lessen accuracy of Hb A1C testing.
Offer urine culture every trimester.

MIDW 305 (13 decks)

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