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Reproductive System > Complications of Labour > Flashcards

Complications of Labour Flashcards

1
Q

What does induction of labour need?

A

Foetal monitoring
Cervical ripening - prostaglandins and balloon

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2
Q

What does induction mean?

A

An attempt is made to instigate labour artificially using medications and/ or devices to ripen cervix followed usually by artificial rupture of membranes

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3
Q

What is the the Bishop’s score?

A

Clinically assess the cervix
Higher the score then the more progressive change there is in the cervix and indicates induction is likely successful

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4
Q

What are the areas assessed in the Bishop’s score?

A

Dilatation
Length of cervix (effacement)
Position
Consistency
Station

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5
Q

When can an amniotomy be perfomed?

A

Once the cervix has been dilated and effaced - Bishops score of 7 is favourable

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6
Q

What is an amniotomy?

A

Artificial rupture of the foetal membranes (waters) usually using amniohook

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7
Q

What is given after amniotomy is performed?

A

IV oxytocin can be used to achieve adequate contractions unless they start spontaneously - aim for 4-5 contractions in 10 minutes

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8
Q

What are the stages of dilatation and effacement?

A

Cervical canal before effacement is before labour
Then partial effacement
Cervix is effaced and dilatation occurs
Then cervix fully dilates

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9
Q

What are the indications for induction?

A

Diabetes
Post dates - term + 7 days
Maternal reason
Foetal reason
Social/ maternal request

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10
Q

What are maternal reasons for induction?

A

Treatment for DVT, maternal age if over 40 and IVF pregnancy

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11
Q

What are foetal reasons for induction?

A

Growth concerns or oligohydramnios

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12
Q

What can inadequate progress in labour be due to?

A

Inadequate uterine activity - power
Cephalopelvic disproportion and obstruction - passages
Malposition and malpresentation - passenger

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13
Q

What is the progress of labour determined by?

A

Cervical effacement
Cervical dilatation
Descent of foetal head through maternal pelvis

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14
Q

What is the process of suboptimal labour in active first stage determined by?

A

Cervical dilatation
Less than 0.5cm per hour for primigravid women
Less than 1cm per hour for parous women

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15
Q

What happens if the contractions are inadequate?

A

Foetal head will not descend and exert force on the cervix and cervix will not dilate

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16
Q

What increases the strength and duration of contractions?

A

IV oxytocin

17
Q

What can stimulation of an obstructed labour result in?

A

Ruptured uterus

18
Q

Describe cephalopelvic disproportion (CPD)

A

Means the foetal head is in the correct position for labour but is too large to negotiate the maternal pelvis and be born
Caput and moulding (skull bones cross in baby) develop

19
Q

What are reasons for obstruction of passage in labour?

A

Placental praevia
Foetal anomaly - hydrocephalus
Fibroids

20
Q

Describe malpresentation

A

Baby isn’t in longitudinal lie in vertex presentation
Is in longitudinal lie in breech presentation or transverse lie in shoulder presentation

21
Q

Describe malposition

A

Much more common
Foetal head being in suboptimal position for labour and relative CPD occurs - occipito-posterior and occipito-transverse

22
Q

What helps identify the position of the baby’s head?

A

Posterior (triangle shaped) and anterior (diamond shaped) fontanelle

23
Q

What can too many contractions (uterine hyper-stimulation) result in?

A

Foetal distress due to insufficient placental blood flow

24
Q

What are the main causes for foetal distress?

A

Hypoxia and infection
Rare - cord prolapse, placental abruption and vases praevia

25
Q

What is foetal well being in labour determined by?

A

Intermittent auscultation of foetal heart
Cardiotocography
Foetal blood sampling
Foetal ECG

26
Q

Describe foetal blood sampling

A

Speculum used to take foetal scalp blood sample
Used when abnormal CTG
Can give a measurement of baby - pH, base excess, lactic acid and can see if in hypoxaemia

27
Q

What are types of operative births?

A

Instrumental - forceps and ventouse
Planned CS
Emergency CS

28
Q

What is the most common mode of birth in Grampain?

A

Spontaneous vaginal birth
Unplanned CS
Planned CS
Forceps
Ventouse
Breech

29
Q

What are some 3rd stage complications in labour?

A

Retained placenta
Post partum haemorrhage - 4Ts
Tears - graze, 1st, 2nd, 3rd and 4th degree

30
Q

What does a 3rd degree tear involve?

A

Anal sphincter complex

31
Q

What does a 4th degree tear involve?

A

Rectal mucosa

Reproductive System (18 decks)

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