Childbirth Flashcards
in stage 1, how often should a doppler of the fetal heart be done?
every 15 mins
in stage 2, how often should a doppler of the fetal heart be done?
every 5 mins
what are the stages of labour? what happens?
1 - dilation of cervix
2 - expulsion of fetus
3 - expulsion of placenta and fetal membranes
in a nulliparous and multparous women, what is poor progress in labour classified as?
nilliparous - <2cm in 4 hrs
multiparous - <2cm in 4hrs or slowing progress
what are 3 causes of poor progress in labour? what measures this?
power
passage
passenger
PARTOGRAM
2 common side effect of diamorphine injection?
itchy nose
respiratory depression
what to give to baby if it is effected by morphine? what would it be suffering from?
naloxone
respiratory depression
where does an epidural block pain fibres from?
T10-S5
nerve supply of uterus and birth canal?
utertus T10-12
birth canal S2, 3, 4
what is primary PPH?
loss of >500mls in first 24hrs after delivery
what is secondary PPH?
excessive blood loss 24hrs after delivery
what increases risk of PPH?
prolonged labour
active management of stage 3 pregnancy
Hx of problems
Tx for PPH?
uterine massage
syntocinon
carboprost
what can be done during active management of the third stage of pregnancy?
syntometerine
oxytocin
controlled cord traction
cord clamping and cutting
signs of placental separation after delivery?
umbilical cord lengthens
blood loss
uterus contracts and hardens
during birth, what does zero fifths palpable mean?
head cannot be felt in abdo, is fully engaged
during birth, what does five fifths palpable mean?
head can be fully felt in abdo
what scoring system can be used for inducing?
bishops
what is the order of mechanisms of labour?
descent flexion IR crowning extension restitution lateral flexion
what happens during descent?
fetus descends into pelvis due to force of contractions
what happens during flexion?
chin touches chest and arms cross
what happens during IR?
head rotates forward 45 degrees as it reaches birth canal
what happens during crowning?
head escapes under pubic arch
what happens during extension?
head extends so it can pass over perineum
what happens during restitution?
shoulders rotate to AP plane
head then restitutes by coming into line with shoulder
what happens during lateral flexion?
anterior shoulder born first via downward traction
lateral flexion so posterior shoulder is delivered
surgical Tx for PPH?
balloon
uterine artery ligation hysterectomy
what bishops score suggests that pregnancy will not require induction?
> 6
when is induction done?
> 12 days after due date
prelabour premature membrane rupture where labour doesn’t start
if a delay in first stage of labour, what are Tx options?
artificial membrane rupture
if already done, oxytocin infusion
if a delay in second stage of labour, what are Tx options? how long is a delay?
instrumental delivery
cesarean
≥ 1hr
who are oxytocin infusions dangerous in?
Hx of cesarean
what type of operative vaginal delivery poses more risk to the child? what is safer for mum?
ventouse > forceps for mum
forceps > ventouse for child
normal fetal HR?
100-160bpm
worrying features of CTG?
brady/tachycardia
reduced variability
decelerations
if a baby is premature, when is this and what should be given?
<37 wks
betamethasone
if post term, what is done? when is this?
41 weeks
membrane sweep
vaginal prostaglandin
oxytocin
