Dysfunctioanl Labor - Moulton Flashcards
What may be the cause of dystocia?
Macrosomia
Shoulder dystocia
Fetal anomalies
Main sx of persistent OP position?
Severe back pain
What is macrosomia?
Large for gestational age?
> 4500 gms
Birth weight > 90% for a given gestational age
Erb-Duschenne injury is to what nerves?
What palsy?
What else?
C5, C6
Upper arm palsy
Most common brachial plexus injury
E before K so C5 before C8
What is the 1st maneuver performed w/shoulder dystocia?
What is it?
McRobert’s
Hyperflexion and abduction of maternal hips
Josh McRoberts is a hyper baby bitch
What is a cephalic replacement last resort maneuver for shoulder dystocia?
Zavanelli
Poor prognosis
What are the risks of artificial membrane rupture?
Cord prolapse
Chorioamnionitis
What is defined as delivery that requires additional obstetric maneuvers following failure of gentle downward traction on the fetal head to effect delivery of the shoulders?
Shoulder dystocia
What forceps are used for persistent OT position?
Keilland
KOT the baby
What secondary maneuver may help w/shoulder dystocia?
Suprapubic pressure
Not fundal pressure
What maneuver places pressure on an accessible shoulder to push it towards the anterior chest wall of the fetus to decrease the bisacrominal diameter and free the impacted shoulder?
Rubin
What maneuver applies pressure behind the posterior to rotate the infant and dislodge the anterior shoulder?
Wood’s corkscrew
What is retraction of the delivered fetal head against the maternal perineum?
Turtle sign
I like turtles
What are the normal limits of the latent phase of labor in a nulliparous woman?
Multiparous?
20 hours
14 hours
What are 4 causes of active phase abnormalities?
Inadequate uterine activity
Cephalopelvic disproportion
Fetal malposition
Anesthesia
What refers to stimulation of uterine contraction when spontaneous contractions have failed to result in progressive cervical dilation or descent of the fetus?
Augmentation
What does a + 50-g glucose screen w/a negative result on 3 hour mean?
RF for macrosomia
ACOG recommends prophylactic C section for babies weighing what in non diabetic pts?
In diabetic pts?
> 5,000 gms
> 4,500 gms
How do you manage persistent OT position?
Start oxytocin
Rotation manually or w/forceps
C section
Minimal effective uterine activity defined how?
3 contractions in a 10 minute period avg 25 mmHg above baseline
Klumpke is what nerve injury?
What palsy?
C8 and 1st thoracic nerve
Lower arm
Persistent OT position w/arrest of descent for a period of 1 hr or more known as what?
Seen at what stations?
Transverse arrest of descent
+1 and +2
What can cephalopelvic disproportion cause?
Failure of descent
What is the minimum max dilation of the cervix in a nulliparous woman?
Minimum descent?
1.2 cm
1 cm
What is the minimum max dilation of the cervix in a multiparous woman?
Minimum descent?
1.5 cm
2 cm
