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Patho 2 > Delivery complications > Flashcards

Delivery complications Flashcards

1
Q

how should you treat bleeding in the third trimester?

A

treat it as a life threatning emergency until proven otherwise

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2
Q

bleeding with abnormal vital signs is considered what CTAS?

A

CTAS 1

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3
Q

what are common risk factors for fetal death?

A
  • maternal obesity
  • uncontrolled diabetes
  • smoking
  • hypertension
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4
Q

what are signs of decomposition of a stillborn fetus?

A
  • skin discoloration
  • nuchal cord
  • malformed or discoloured extremities
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5
Q

when should you not initiate resus of a fetus?

A
  • signs of decomposition present
  • fetus is clearly not viable ie. >20 weeks
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6
Q

what is the defined birth weight for macrosomia?

A

=>4000 grams

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7
Q

shoulder dystocia can lead to what type of injury?

A

bracial plexus injuries

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8
Q

what is group B Streptococcus? how does it pose a risk to the fetus?

A

GBS is a common bacteria found in the rectum and vagina.

it can be transmitted to infants during vaginal delivery

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9
Q

what are the potential infections GBS can cause the newborn?

A
  • pneumonia
  • sepsis
  • meningitis
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10
Q

what are causes for DIC?

A
  • amniotic fluid embolism
  • placental abruption
  • eclampsia/HELLP syndrome
  • retained dead fetus
  • sepsis
  • trauma
  • hepatic failure
  • hypothermia
  • transfusion reactions
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11
Q

clinical presentation of DIC

A
  • hypotension/ shock
  • respiratory distress
  • bleeding from multiple sites
  • petechiae
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12
Q

where does shoulder dystocia typically occur?

A

anterior shoulder at the symphysis pubis

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13
Q

while rare the posterior shoulders can get stuce where?

A

against the sacrum

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14
Q

what are the signs of turtle dystocia?

A
  • turtle sign
  • cyanosis of fetal head
  • arrest of decent
  • no head rotation
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15
Q

what potential complications does shoulder dystocia carry

A
  • entrapment of umbilical cord
  • ches compression which limits babies abbility to breath
  • brachial plexus injuries
  • brain damage or death
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16
Q

when does irreversible hypoxic brain injury occur if the baby with shoulder dystocia remains stuck?

A

8 minutes

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17
Q

what is ALARM

A

A systemic approach in managing shoulder dystocia
A: ask for help
L: lift the legs in mcroberts position
A: Apply suprapubic pressure
R : Roll over
M : deliver the posterior arm as a last resort

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18
Q

why does mcrobers position help deliver the baby?

A
  • widens the pelvic outlet
  • alings the pelvic angle and straigtens the sacrum to open the birth canal
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19
Q

why does applying suprapubic presure help deliver the baby?

A

it pushes the shoulder downward, allowing the shoulder to pass under the symphysis pubis

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20
Q

shoulder dystocia is best mannaged with three people, where are all three people placed?

A

1 ; managing the legs
2 ; applying suprapubic pressure
3 ; overseeing the delivery (ME)

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21
Q

you must record all key events during ALARM. what are you recording?

A
  • time of head delivery
  • time of each maneuver
  • overall outcome
22
Q

rolling over the mom to deliver the baby is known as?

A

gaskin maneuver

23
Q

what does the gaskin maneuver help with?

A

increasing pelvic diameter

24
Q

what position should the mother be in if you are delivering the posterior arm?

A

lithotomy position (lying down) (can be done during the gaskin maneuver

25
Q

what is the definition of breech birth?

A

the baby is delivered feet or buttocks first

26
Q

complete breech?

A

buttocks presents first

27
Q

incomplete breech

A

one or both legs present first

28
Q

frank breech

A

buttocks presents and legs are extended straight up

29
Q

what are signs of imminent breech birth

A
  • fresh dark meconium
  • visible buttocks or legs
  • progression of the buttocks and legs with each contraction
30
Q

why is hands off preformed during breech births?

A

this avoids stimulating the baby and prevents premature respirations of amniotic fluid, meconium , or other substances

31
Q

once the umbilicus is visble during a breech birth, how much time do you have to deliver the baby?

A

4 minutes

32
Q

what timmings do you have to document during a breech birth?

A
  • time the umbilicus is exposed
  • time the hair line is exposed
  • any time you provide manual assistance
33
Q

what are the indications for the MSV maneuver?

A
  • umbilicus has been exposed for 3 minutes without further progression
  • hair line is visible
34
Q

when assisting the legs to deliver, what part of the legs are you grabbing?

A

the popliteal fossa

35
Q

what is limb presentation and what does it indicate?

A

when a single limb (arm or leg) presents through the birth canal which indicates transverse lie

36
Q

what actions should you take with limb presentation

A
  • do not attempt delivery
  • encourage panting
  • wrap the limb with a dry blanket
  • position the mother in the exaggerated sims position
  • use gravity to delay labour
37
Q

what are steps for the exaturates sims position?

A
  • place mother on left side
  • elevate hips using cushions to raise pelvis ubove shoulders
  • back ar is placed behind for stability
38
Q

why are you choosing to place the mother on their left side during exaturated sims position?

A

it helps to maintain blood flow to the Inferior vena cava to support maternal and fetal circulation

39
Q

what is a prolapsed umbilical cord?

A

when the umbilical cord emerges from the uterus ahead of the presenting part of the baby

40
Q

what actions should be taken if there is cord prolapse?

A
  • knee to chest position
  • exaggerated sims positon
  • gently replace cord back to the vagina
  • apply digital pressure to lift parts off the cord
41
Q

what does oxytocin administration do?

A

stimulates uterine contraction to reduce bleeding

42
Q

what is a retained placenta defined as?

A

a placenta not delivered within 30 mins post birth

43
Q

indications for uterine massage?

A
  • after the placenta is delivered and the patient is unstable (shock or bleeding)
  • the uterus is soft and lacks tone
44
Q

what is the goal of uterine massage

A
  • stimulate the uterus to contract
  • reduce bleeding by promoting uterine tone
45
Q

what are signs for placental seperation

A
  • lengthening of the umbilical cord
  • increased vaginal bleedng
46
Q

when should you use bi manual compression? what does it help with?

A

for patients with PPH and an undelivered placenta. it helps to reduce bleeding while awaiting surgery

47
Q

what does urination do post delivery?

A
  • stimulates oxytocin releae
  • encourages uterine contraction
  • reduces the risk of hemorrhage
48
Q

how much does the risk of PPH increase if the placenta is not delivered after 30 mins

A

risk increases 6 fold

49
Q

why does the blood pressure have to be under 160 systolic when administering Oxytocin

A

because oxytocin can inclrease bloodpressure

50
Q
A

Patho 2 (30 decks)

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