Complications of Labour II Flashcards
Define Perinatal asphyxia [1]
When does it occur? [1]
(It is anon-specific termthat involves a complex range of problems): failing to initiate and sustain breathing at birth
Problem can happen before, during or immediately after delivery
What are indications of perinatal asphyxia? [6]
Poor skin colour
Low heart rate
Weak muscle tone
Gasping
Weak breathing
Meconium-stained amniotic fluid
Perinatal apnea is relatively normal. What type of breathing would you be concerned about with a newborn? [1]
Short gasping breaths (want deeper breaths to give sufficient o2 and distribute surfactant)
What treatment can you give for perinatal asphyxia? [3]
Treatment of perinatal asphyxia can include:
- providing oxygen to the mother
- carrying out a caesarean delivery
- after delivery: mechanical breathing or medication
Explain potential complications of secondary perinatal apnea [3]
Not getting o2 in lungs and distributing surfactant.
Can lead to hypoxaemia: brain damage, heart damage and cause resp. acidosis.
Score system used to investigate perinatal asphyxia? [1]
What score would indicate [1]
APGAR score
Low score (0-3) for > 5 mins
What are the three types breech pregnancies?
Frank: Has most favourable outcomes for vaginal deliveries
Complete
Footing
What are the three types breech pregnancies?
Frank: Has most favourable outcomes for vaginal deliveries
Complete
Footing
Explain the pathophysiology of placenta previa [1]
What is the main symptom of placenta previa? [1]
Placenta is attached in the lower portion of the uterus, lower than the presenting part of the fetus.
Main symptom: bleeding without pain in third trimester
(should have been picked up by ultrasound before birth)
What are the 4 types of placenta previa? [4]
Minor praevia, or grade I – the placenta is in the lower uterus but not reaching the internal cervical os
Marginal praevia, or grade II – the placenta is reaching, but not covering, the internal cervical os
Partial praevia, or grade III – the placenta is partially covering the internal cervical os
Complete praevia, or grade IV – the placenta is completely covering the internal cervical os
What type of delivery occurs if placenta previa occurs? [1]
What can plecenta previa increase risk of? [1]
Treatment of placenta previa? [1]
Placenta previa:
- C section only
- Increases the liklihood of placenta accreta (when placenta becomes inseperable from uterus
- Treat with blood transfuison
Define cephalopelvic disproportion [1]
What can it be caused by? [3]
When a baby’s head is unable to fit through the mother’s pelvis
Causes include:
- Baby is large or has a large head size (e.g. Craniosynostosis (if cranial sutures have already closed before birth)
- Baby is in an unusual position
- Mother’s pelvis is small or has an unusual shape
Explain the reasons that increase the risk of uterine rupture [4]
- Distension of uterus due to polyhydramnios or large baby
- Maternal age 35 + (uterus is less stretchy)
- Previous C section: scar.
- Use of instruments in vaginal delivery
What are potential complications of uterine rupture to mother [3] & baby [3]
Baby:
* Oxygen deprivation of baby: C section required
* Aspiration of amniotic fluid
* Higher chance of infection if delivery takes place in an unsterile location
Mother:
* Mother XS bleeding
* postpartum shock
* Increases risk of tearing and laceration to the cervix and vagina
Name 4 signs of uterine rupture
Signs of a uterine ruptureinclude:
- Abnormal heart rate in the baby
- Abdominal pain and uterine tenderness
- Vaginal bleeding
- Slow progress in labour
- Altered uterine contractions
- Rapid heart rate and low blood pressure in the mother
