delivery

Question 1

(For partograms) How often are you checking fetal heart rate?

Answer 1

Every 5 mins

Question 2

How often are you checking maternal pulse, BP, temperature?

Answer 2

Every 30 mins

Every hour for T

Question 3

Urinalysis?

Answer 3

Every hour

Question 4

How often do you do a PV exam?

Answer 4

Every 4 hours

Question 5

At which point do you start a partogram?

Answer 5

3 cm dilatation

Question 6

signs of first stage labour?

Answer 6

Show= bloody mucous
painful contractions
ROM

Question 7

what is normal for fluctuations in fetal HR?

Answer 7

10-15

Question 8

When should you encourage pushing, until when you discourage it?

Answer 8

until fully dilated

Question 9

How should a woman push?

Answer 9

2-3 times after every contraction

Question 10

What position should she be in?

Answer 10

LLP or kneeling

Question 11

What are you doing once the head is born?

Answer 11

Give ergometrine/oxytocin to ppte stage 3

Question 12

After anterior shoulder out?

Answer 12

Pull fetus anteriorly over pubic symphysis

Question 13

How would you clamp the cord?

Answer 13

Clamp twice, cut 1-3 mins after delviery

Question 14

What should you immediately do wrt baby??

Answer 14

Aspirate mucous
General check
Vitamin K
APGAR score
label
keep warm
give baby to mum- start suckling immediately

Question 15

What do you do if there’s a cord prolapse?

Answer 15

Mother should be on all fours, and readied for a c-section
Apply gentle pressure to presenting part
Consider tocylytics such as terbutaline
If it’s extruded from the introitus keep warm

Question 16

What do you do in shoulder dystocia?

Answer 16

McRoberts:
Lie on back, hips hyperflexed
Suprapubic pressure to rotate shoulders
Via the vagina, place your hands on the back of the baby's shoulders to rotate them
Grasp the posterior arm and pull

Or try the gaskin manouvre- on knees, arch back to open pelvic outlet

c/s?

Question 17

How do you deal with secondary uterine inertia?

Answer 17

oxytocin or instrumental

Question 18

OP?

Answer 18

maybe delivery

forceps/ c/s?

Question 19

Narrow mid-pelvis?

Answer 19

instrumental, c/s?

Question 20

PPH? Rx?

Answer 20

A, B, C
Fluids
IV Oxytocin, gentle suprapubic massage
X-match
Catheterise

Question 21

the head is on the peritoneum, lift out delivery

Answer 21

Wrigley’s- short forceps

Question 22

higher deliveries

Answer 22

neville-barneys- long forceps

Question 23

suitable for rotation

Answer 23

Kiellands forceps

Question 24

goes over the posterior fontanelle, head not higher than ischial spines

Answer 24

Ventousse (vacuum)

Question 25

Risk factors for cord prolapse

Answer 25

Breech
ARM
Polyhydramniois
abnormal lie
MP