Complications of Labor and Delivery Flashcards
What is used to reduce incidence of respiratory distress syndrome?
Betamethason
What medications can be used to prolong gestation and how long do they work?
tocolytics, but only prolong gestation by 48 hours Ritodrine Tertbutaline Magnesium sulfate CCBs (nifedipine) Prostaglandin inhibitors (indomethacine) Oxytocin antagonists
What are side effects of tertbutaline
Maternal death cardiac events transient hyperglycemia hypokalemia pulmonary edema
What are signs of magnesium toxicity?
respiratory depression, hypoxia, cardiac arrest
What are the risks of PPROM?
Chorioamnionitis
placental abruption
cord prolapse
What is management of PPROM?
Ampicillin +/- erythromycin
Check lung maturity, give corticosteroids
What are the etiologies of fetal bradycardia?
Preplacental - hypotension due to epidural placement, seizure, PE, MI, resp failure
Uteroplacental - abruption, infarction, hemorrhaging previa, uterine hyperstimulation
Postplacental - cord prolapse, cord compression, rupture of vessel (vasa previa)
What is management of prolonged FHR bradycardia?
Moved to left or right to resolve compression Maternal O2 facemask IV hydration if hypotensive Nitroglycerin if uterus is tetanic C-section if previa or abruption
What are risk factors for shoulder dystocia?
macrosomia, gestational diabetes, prior shoulder dystocia, maternal obesity, postterm, prolonged second stage of labor
What are complications of shoulder dystocia?
Erbs palsy Clavicle fracture Phrenic nerve palsy hypoxic brain injury death
What is management of shoulder dystocia?
McRoberts - hyperflexion of hips
Suprapubic pressure
Rubin maneuver (moving free shoulder closer to chest of fetus to decrease diameter)
Wood’s corkscrew = pressure behind posterior shoulder to dislodge/rotate anterior shoulder
Delivery of posterior shoulder
Zavanelli = pushing head back in and doing c section
When is uterine rupture suspected?
FHR decel in patients with prior uterine scars
May feel popping sensation or sudden abdominal pain
How is maternal hypotension treated?
BP
How is amniotic fluid embolus diagnosed?
Finding of fetal cells in pulmonary vasculature at autopsy
