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Human Development 2 > Complications of Labour > Flashcards

Complications of Labour Flashcards

1
Q

What are the three things that normal labour depends on

A

The Passenger - the baby
The Passages - the pelvis
The Powers - the contractions

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2
Q

what are any issues in labour related to

A

The Passenger - the baby
The Passages - the pelvis
The Powers - the contractions

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3
Q

describe what the baby is attached to within the womb

A

within the womb there is the amniotic sac which is what the baby is in, it is then attached to the placenta which attaches this to the mother

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4
Q

what are the two stages of the first stage of labour

A

latent phase

active phase

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5
Q

define the two stages of the first state of labour

A

latent phase 0-4cm

active phase - 4-10cm

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6
Q

what is the difference between primigravida and multigravida

A

primigravida - 1st baby

multigravida - multiple baby

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7
Q

describe how much dilation occurs in the primigradia and multigravida phase per hour

A

Primigravida - 0.5cm to 1 cm per hour

Multigravida - 1cm per hour

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8
Q

what are the two phases of the 2nd stage of labour

A
  • passive stae

- active stage

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9
Q

describe the passive and active stage

A

Passive stage – fully dilated so give them bit of time for head to descend naturally

Active part – active pushing and delivery of the baby

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10
Q

How long does the 2nd stage of labour last

A

2nd stages lasts no more than 2 hours for a primigravida and one hour for a multigravida

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11
Q

what is the 3rd stage of labour

A

From delivery of baby to expulsion of placenta

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12
Q

How long does the 3rd stage of labour take

A

Duration – in both primigravidae & multigravidae =20-30 mts

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13
Q

list the problems that can occur with the baby in labour

A
  • Size, Number, the way they Lie
  • Presentation & Position
  • Anatomical Abnormalities
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14
Q

when does a baby become viable

A

when it is larger than 500g at 22 weeks

- viable at 24 week

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15
Q

what is macrosomia

A
  • baby larger than the 95%th percentile
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16
Q

what can cause macrosomia

A

Maternal diabetes – espically if not diagnosed or controlled

Maternal obesity

Previous large babies

Prolonged pregnancy

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17
Q

what is multiple pregnancy incidence of twins, triplets, quads

A 
Twins = 1 in 80 
Triplenets = 1 in 6400
Quads = 1 in 512000
18
Q

what causes monozygotic twinning

A

chance event

19
Q

What causes dizygotic twinning

A
  • Racial predisposition,
  • Fertility treatments
  • Older ages,
  • parity>5
20
Q

what does
- dichrionic and diamninotirc
- what does monochorionic and diamniotic
- what is monochorionic and mono amniotic
in twins mean?

A
  • dichrionic and diamninotirc= two placentas and two amniotic sac in twins
  • what does monochorionic and diamniotic = one placenta and two amniotic sacs
  • what is monochorionic and mono amniotic = one placenta and one amniotic sac
21
Q

What happens in a twin to twin transfusion

A

Twin to twin transfusion one twin takes more nourishment than the other twin and this can cause problems for both of them

22
Q

what happens if the baby is in an abnormal position

A
  • they can have an affect it can increase the risk of complications and needing a breach birth
  • for example if the legs come out which are smaller first this can lead to the head being stuck in as it is not fully dilated therefore can cause strangulation
23
Q

how do you treat an abnormal position of a baby

A

External cephalic version

  • this is when you try and turn your baby
  • do it after 37 weeks as baby is still likely to turn by itself
  • if this doesn’t work then do a C section
24
Q

what are the problems with passage

A
  • contracted pelvis
  • placenta praaevia
  • soft tissue tumours
  • pendulum abdomen
25
Q

describe the different problems with passage

A

Contracted pelvis – malnourished or have babies younger when the pelvis haven’t formed yet

Placenta praevia – haemorrhage

Soft tissue tumours = fibroids blocking the way or a big fibroid in the lower part of the uterus

Pendulous abdomen- those that have lots of babies before have lost the muscle tone in the tummy it is not as easy for the baby to come out

26
Q

what is the most favourable choice for a pelvis in pregnancy

A

Gynaecoid

27
Q

what is the smallest diameter that a baby can go through

A

11cm in diameter

28
Q

what happens in a placenta preaeiva

A
  • this is when the placenta covers the os therefore the baby cannot leave the uterus
  • need a C section
29
Q

what are the different problems you can have with the power of contraction

A

Uterine inertia

Inco-ordinate contractions

Hypertonic contractions

Uterine Rupture

30
Q

what happens in a uterine rupture

A
  • happens when people have fibroids removed, C sections vacation after miscarriage or a procedure in the uterus
  • blood supply to the baby stops
31
Q

what are the signs of a poor fit

A

Failure of progressive cervical dilatation

Failure of descent of the presenting part

Moulding

Caput

32
Q

What is caput

A

swelling of the head

33
Q

what is. moulding

A
  • in labour it is normal for the bones of the skull to get closer and overlap

stage 1; when the bones touch
stage 2 - overlap but can be pushed back
stage 3 - overlapped and cannot be pushed back in place

34
Q

What is Cephalopelvic disproportion’ (CPD) or ‘Fetopelvic disproportion’ (FPD)

A

this is when there is a disproportional fit between the baby and pelvis

35
Q

How do you manage failure to progress

A

Powers – ‘uterine inertia’
= give Syntocinon judiciously – artificial oxytoxcin, 3 to 4 in 10 lasting a minute each

Passenger – ‘malpresentation’ or ‘malposition’
= consider ECV/ rotational forceps or ventouse delivery/ Caesarean section

Passages – ‘contracted pelvis’ or ’rigid cervix’
= Caesarean section

36
Q

what are the two signs of fatal distress in labour

A
  • Meconium-stained liquor

- fetal heart rate abnormalities

37
Q

describe how meconium can be a sign of distress

A
  • poo in the abdomen that can be due to distress.
  • isn’t always a sign of stress but can me
  • if it is thicker it is more likely due to distress whereas if it is inner it is less likely to be due to distress
  • meconium can be inflammatory to the lungs
38
Q

what do we look for in fetal heart rate abnormalities

A

Baseline rate (bradycardia <110/mt; tachycardia >160/mt normal between 110-160mt)

Reduced baseline variability (<5/mt – how wobbly the line is if flat line this is bad ) )– if not variable this is an issue

Decelerations (early, variable and late – can be a sign of hypoxia

39
Q

what is chromaminotis

A
  • this is an infection around the baby where water has ruptured into it for a number of days
  • can cause a raise in the heart rate and then we need to deliver the baby
40
Q

what are the problems with the 3rd stage of labour

A
  • Retained placenta
  • Uterine atony
  • Soft tissue lacerations
  • Uterine inversion
41
Q

Describe the problems with the 3rd stage of labour

A

Retained placenta – placenta should be out before an hour and normally within 30 minutes if not out in this time then manaual removal of the placneta

Uterine atony – cytosnoe?, emptying the bladder

Soft tissue lacerations

Uterine inversion

42
Q

what is placenta accrete

A

this is when the placenta hasn’t attached properly therefore it invades the muscle and then can further go in an invade other structure s

  • C section needs to be done
  • then sometimes a hysterectomy

Human Development 2 (34 decks)

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