Complications of pregnancy

Question 1

active management of 3rd stage of labour

Answer 1

Uterotonic:
* Syntocinon (oxytocin)
* Syntometrine (oxytocin + ergotmetrine)
– Cord clamped
– Controlled cord traction

Question 2

shoulder dystocia risk factors

Answer 2

Antenatal: Previous shoulder dystocia, fetal
macrosomia, diabetes, BMI >30, short stature

– Intrapartum: Slow 1st and/or 2nd stage labour,
induction of labour, instrumental delivery

Question 3

shoulder dystocia maternal complications

Answer 3

PPH, genital tract trauma, pelvic injuries

Question 4

shoulder dystocia foetal complications

Answer 4

Hypoxia, brachial plexus injury, fracture of
clavicle/humerus, intracranial haemorrhage, death

Question 5

First degree tear

Answer 5

Injury to perineal skin only

Question 6

Second degree tear

Answer 6

involving perineal skin and muscle but not anal sphincters

Question 7

Third degree tear

Answer 7

Injury involving anal sphincters
3A <50% external anal sphincter
3B >50% external anal sphincter
3C Involvement of both external and internal anal sphincter

Question 8

Fourth degree tear

Answer 8

Disruption of anal epithelium/mucosa