Complications of labour Flashcards
Name the 3 key factors on which labour depends upon
The passenger
The passages
The powers
Name the 2 phases of the first stage of labour
Latent phase
Active phase
What is the cervical dilation in the latent phase of stage 1
0-3CM
What is the cervical dilation in the active phase of stage 1
3-10cm
What is the expected rate of dilation in primigravida
1-3cm per hour
What is the expected rate of dilation in multigravida
3-6cm per hour
How long does the second stage of labour last in
a) primigravida
b) multigravida
a) 40 minutes
b) 20 minutes
Name the two phases of the second stage of labour
Propulsive phase
Expulsive phase
What is the propulsive phase
From full dilation to presenting part reaching pelvic floor
What is the expulsive phase
From reaching pelvic floor to delivery of baby
What is the third stage of labour and how long does it last
Delivery of baby to expulsion of placenta
20-30 minutes
What is macrosomia
A baby born significantly larger than average
>4000g birth weight
What factors are associated with macrosomia (4)
- Maternal diabetes
- Maternal obesity
- Previous large babies
- Prolonged pregnancy
How often do the following occur
a) twins
b) triplets
c) quads
a) 1 in 80
b) 1 in 6400
c) 1 in 512000
What is the difference between monozygotic and dizygotic twins
MONO: develop from one zygote that splits into 2 embryos (identical)
DI: fraternal- develop from 2 different eggs
When is dizygotic twinning more common
Fertility treatment
Older ages
In which amniotic/ chorionic states are twins more dangerous
Monochorionic diamniotic
Monochorionic monoamniotic
Name some common complication of multiple pregnanies (6)
Pre-eclampsia Congenital abnormalities Intrauterine growth restriction Polyhydramnios Malpresentation Miscarriage/ preterm labour
Define polyhydramnios
State of having too much fluid in amniotic sac
Name 4 problems that can happen with the ‘passage’
Contracted pelvis
Placenta Praevia
Soft tissue tumours
Pendulous abdomen
What is the curve of carus
Arc corresponding to pelvic axis
Name 4 problems that can happen with the ‘powers’
Uterine inertia
Inco-ordinate contractions
Hypertonic contractions
Uterine rupture
Define uterine inertia
Absence of effective uterine contractions during labour
Define hypertonic contractions
Series of single contractions lasting 2 minutes or more, or a contraction frequency of five or more a minute
What are 4 signs of a poor fit
Failure of progressive cervical dilation
Failure of descent of the presenting part
Moulding
Caput
What is meant by caput
Caput is the diffuse swelling of the scalp caused by pressure of the scalp against dilating cervix during labour
What is cephalopelvic disproportion
Baby’s head too large to fit through pelvis of the mother
What is fetopelvic disproportion
Baby unable to pass through the pelvis
How is uterine inertia treated
Give syntocinon
What are the options for managing malpresentation/ malposition
External cephalic version: manual procedure to reposition baby using hands on mothers abdomen
Rotational forceps
C section
What should be done in cases of contracted pelvis/ rigid cervix
C section
How does meconium appear if there is foetal distress
Stained liquor
Name 3 foetal heart abnormalities are signs of foetal distress in labour
Baseline rate (brady/ tachycardia( Reduced baseline variabilty Decelerations
Name 4 issues that can arise in the third stage of labour
Retained placenta
Uterine atony
Soft tissue lacerations
Uterine inversions
