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HD2 > Complications of Labour > Flashcards

Complications of Labour Flashcards

1
Q

What are the 3 key factors in labour?

A

Passenger
Passages
Power

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2
Q

What are the phases in 1st stage labour?

A

Latent Phase - 0-3cm cervical dilation

Active Phase - 3-10cm cervical dilation

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3
Q

What is the dilation for primigravida and multigravida in 1st stage of labour?

A

Primigravida: 1-3cm/hr
Multigravida: 3-6cm/hr

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4
Q

How long is the 2nd stage of labour for primigravida and multigravida?

A

Primigravida: 40 minutes
Multigravida: 20 minutes

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5
Q

What are the phases in 2nd stage of labour?

A

Propulsive: from full dilation to present part reaching pelvic floor
Expulsive: from reaching pelvic floor to delivery of baby

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6
Q

What is the 3rd stage of labour?

A

From delivery of baby to expulsion of placenta

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7
Q

How long is the 3rd stage of labour in primigravida and multigravida?

A

20-30 minutes for both

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8
Q

What is the fetal size throughout pregnancy?

A
  • 22 weeks: 500g
  • 28 weeks: 1000g
  • 32 weeks: 1800g
  • 36 weeks: 2500g
  • 40 weeks: 3300g
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9
Q

What is macrosomia?

A

Fetal size significantly larger than normal

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10
Q

What is macrosomia caused by?

A

Maternal diabetes
Maternal obesity
Previous large babies
Prolonged pregnancy

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11
Q

How many people have twins?

A

1 in 80

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12
Q

How many people have triplets?

A

1 in 6400

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13
Q

How many people have quads?

A

1 in 512 000

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14
Q

What is the cause of monozygotic twins?

A

Chance

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15
Q

What is the cause of dizygotic twins?

A

Racial predisposition
Fertility treatments
Older ages

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16
Q

Define diamniotic foetuses?

A

In separate amniotic sacs

17
Q

Define dichorionic foetuses?

A

Different placental blood supply

18
Q

What are the symptoms of multiple pregnancy?

A

Anaemia -> pre-eclampsia
Congenital anomalies
Intrauterine growth restriction
Polyhydramnios

19
Q

What is an abnormal fetal position?

A 
'breech' = wrong way around
sideways = do cesarian (uterus not developed for birth)
20
Q

What is external cephalic version?

A

Physically move fetus after giving uterine muscle relaxation

21
Q

What are the main 4 problems with the passage?

A
  • contracted pelvis (if too small baby cannot fit)
  • placenta praevia
  • soft tissue tumours (fibroids, if at bottom of uterus)
  • pendulous abdomen (loose muscular walls)
22
Q

What are the 4 main problems with powers?

A
  • uterine rupture
  • poor fit (cephalopelvic disproportion) or (fetopelvic disproportion)
  • uterine inertia (absence of effective contractions)
  • in-coordinate contractions, hypertonic contractions
23
Q

What is uterine rupture?

A
  • patient has had fibroids removed/C section/evacuation after miscarriage/miscarriage/uterus procedure
  • dangerous as stops blood supply to fetus
24
Q

What is poor fit indicated by? (CPD or FPD)

A
  • failure of progressive cervical dilatation
  • failure of descent of presenting part
  • moulding (bones of infant’s skull overlap each other)
  • caput (swelling of infant’s scalp)
25
Q

How do you manage uterine inertia?

A

Give syntocinon (oxytocin)

26
Q

How do you manage passenger failure?

A
  • consider ECG/rotation forceps/C section
27
Q

How do you manage passage failure?

A

C-section

28
Q

What are signs of fetal distress in labour?

A
  • meconium (faeces in abdomen due to distress)
  • fetal heart abnormalities (bradycardia, tachycardia)
  • decelerations
29
Q

What are some 3rd stage problems?

A
  • retained placenta
  • uterine anatomy
  • soft tissue lacerations
  • uterine inversion
  • placenta accreta
30
Q

What is placenta accrete?

A

Blood vessels and other parts of placenta grow too deeply into uterine wall

31
Q

What happens in the 1st phase of labour?

A

Dilatation of the cervix

32
Q

What happens in the 2nd phase of labour?

A

Movement of the baby down towards pelvic floor to go through it pass out of passage

33
Q

What happens in the 3rd stage of labour?

A

From delivery of fetus to placenta delivery

HD2 (22 decks)

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