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HD2 > Complications Of Labour > Flashcards

Complications Of Labour Flashcards

1
Q

3 stages of labour

A

Dilation
Birth
Afterbirth

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2
Q

When does mother get urge to push during labour

A

Transition phase of dilation

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3
Q

Diameter of cervix when fully dilated

A

10cm+

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4
Q

Which shoulder is normally delivered first

A

Anterior

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5
Q

Labour lengths defined as failure to progress

A

First delivery - 20+ hrs
2nd+ delivery - 14+hrs

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6
Q

In which phase of labour is failure to progress most dangerous

A

Active

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7
Q

Causes of prolonged labour

A

Slow cervical dilation
Slow effacement
Large baby
Small birth canal/ pelvis
Multiple delivery
Worry, stress, fear
Pain medications

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8
Q

Labour inducing medications

A

Oxytocin
Misoprostal
Mifepristone
Oestrogen pessary

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9
Q

Surgical management of failure to progress

A

Membrane sweep
C section

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10
Q

Management of failure to progress

A

Wait
Labour inducing medications
Surgery

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11
Q

Membrane sweep

A

Digitally push amniotic sac away from uterine wall to make it easier to fully engage cervix

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12
Q

Instruments used in labour

A

Forceps
Ventouse

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13
Q

Indications for forceps or ventouse delivery

A

Maternal exhaustion
Conditions where expulsive efforts prohibited
Breech
Fetal compromise
Low birth weight
Post maturity

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14
Q

Where would the vacuum cup be aimed in a ventouse delivery

A

Back of head

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15
Q

Forceps delivery complications

A

Bruising
Marks on skin
Cephalohematoma
Retinal haemorrhage
Skull fracture
Permanent nerve/brain damage
Soft tissue damage in mother

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16
Q

Ventouse delivery complications

A

Scalp abrasion/laceration
Scalp necrosis
Cephalohematoma
Intracranial haemorrhage
Retinal haemorrhage
Vaginal laceration from entrapment of mucosa by suction cup

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17
Q

Are forceps or ventouse more traumatic to mother and baby

A

Forceps

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18
Q

Causes of non reassuring fetal status

A

Insufficient oxygen levels
Maternal anaemia
Pregnancy induced hypertension
IUGR
meconium stained amniotic fluid

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19
Q

How can oxygen saturation be measured in the fetus during delivery

A

Scalp electrode

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20
Q

How many attempts can be made at a ventouse or forceps delivery

A

3

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21
Q

Characteristics linked to non reassuring fetal status

A

Irregular heartbeat
Muscle tone problems
Movement problems
Low amniotic fluid volume

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22
Q

How is fetal status monitored

A

Heart rate
Oxygen status

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23
Q

Cardiotocography

A

Continuous fetal heart rate monitoring while in labour

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24
Q

What can cause acceleration of fetal heart rate during delivery

A

Fetal movement
Scalp stimulation

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25
Q

What indicates the fetal head is compressed and the fetus is in the correct position during delivery

A

Early heart rate deceleration

26
Q

What can cause late decelerations in fetal heart rate

A

Placental insufficiency

27
Q

How does cord compression affect fetal heart rate

A

Variable decelerations - Abrupt decrease with rapid recovery

28
Q

How can non reassuring fetal status be managed

A

Change mothers position
Increase maternal hydration
Maintain maternal oxygenation
Amnioinfusion
Tocolysis
IV hypertonic dextrose
C section

29
Q

Tocolysis

A

Temporary stoppage of contractions to delay preterm labour

30
Q

Amnioinfusion

A

Fluid inserted into amniotic cavity to relieve pressure on umbilical cord

31
Q

Perinatal asphyxia

A

Failure to initiate and sustain breathing at birth

32
Q

What can perinatal asphyxia lead to

A

Hypoxaemia
High CO2 level
Acidosis
CV, neuro, and organ problems

33
Q

Symptoms of perinatal asphyxia before birth

A

Low HR
low pH
Low oxygen level

34
Q

What does APGAR score assess

A

Appearance
Pulse
Grimace
Activity
Respiration

35
Q

Perinatal asphyxia signs at birth

A

APGAR score below 3
Poor skin colour
Low HR
Weak muscle tone
Gasping
Weak breathing
Meconium stained amniotic fluid

36
Q

Perinatal asphyxia treatment

A

Providing oxygen to mother
C section
Stimulate baby
Mechanical breathing
Medication

37
Q

What does a baby being born stained green indicate

A

Meconium released in utero

38
Q

Shoulder dystocia

A

Head delivered vaginally but shoulders get stuck

39
Q

Shoulder dystocia management

A

Changing mothers position
Manually turning baby’s shoulders - mcroberts manoeuvre
Episiotomy

40
Q

What complications can shoulder dystocia lead to in the fetus

A

Brachial plexus injury - erb duchenne palsy
Humerus/ collar bone fracture
Hypoxic ischemic brain injury

41
Q

What can shoulder dystocia lead to in the mother

A

Tearing
Bleeding

42
Q

How much blood does the mother ususally lose in a single vaginal delivery

A

500ml

43
Q

How much blood does a mother use in a single C section

A

1000ml

44
Q

What is the most common cause of postpartum haemorrhage

A

Lack of uterine tone

45
Q

What causes postpartum haemorrhage

A

Uterine contractions after placenta expelled too weak to compress blood vessels where placenta attached to uterus

46
Q

What can postpartum haemorrhage lead to

A

Low blood pressure
Organ failure
Shock
Death
Lack of nutrition in milk

47
Q

What can increase the chance of postpartum haemorrhage

A

Placental abruption
Placenta praevia
Uterine overdistension
Prolonged labour
Forceps or ventouse
General anaesthesia
Drugs to induce/stop labour
Infection
Obesity
Cervical, vaginal, uterine Blood vessel tears
Hematoma
Blood clotting disorders
Uterine rupture

48
Q

Postpartum haemorrhage treatment

A

Erogotamine
Uterina massage
Balloon tamponade
Removal of retained placenta
Uterine packing
Tying off vessels
Surgery to find bleeding cause
Hysterectomy

49
Q

3 types of breech

A

Frank breech - buttocks first
Complete breech - feet first
Footing breech - legs first

50
Q

Management of malposition

A

Manually change position
Forceps
Episiotomy
C section

51
Q

What makes breech position more likely

A

Multiple pregnancy
Oligohydramnios/Polyhydramnios
Placenta praevia
Uterine fibroids

52
Q

Placenta praevia

A

Placenta covers cervix opening

53
Q

Placenta praevia treatment

A

Bed rest
Supervised rest in hospital
Blood transfusion
C section

54
Q

Cephalopelvic disproportion

A

Baby’s head unable to fit through mothers pelvis

55
Q

Cephalopelvic disproportion management

A

C section

56
Q

What increases uterine rupture risk

A

Previous c section
Labour induction
Large baby
Polyhydramnios
Maternal age 35+
Use of instruments in delivery

57
Q

Uterine rupture management

A

Deliver at hospital
C section
Blood transfusion

58
Q

Uterine rupture signs

A

Abnormal fetal HR
Abdo pain
Uterine tenderness
PV bleeding
Slow progress in labour
Rapid HR and low BP in mother

59
Q

What complications can uterine rupture lead to

A

Fetal Oxygen deprivation
Excessive bleeding
Cervix/vaginal tears
PP shock
Fetal Aspiration of amniotic fluid
Infection

60
Q

Precipitous labour

A

Labours lasts less than 3 hrs

61
Q

What increases chance of precipitous labour

A

Small baby
Uterus contracts efficiently and strongly
Compliant birth canal

62
Q

When can precipitous labour starts

A

1st stage of labour
2nd stage of labour

HD2 (23 decks)

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