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Obstetrics > Extras > Flashcards

Extras Flashcards

1
Q

How do you measure the foetal heart rate in intermittent auscultation?

A

Pinard stethoscope

hand held Doppler

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2
Q

Name three methods of continuous foetal monitoring?

A

CTG
scalp ECG
abdo ECG

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3
Q

What does ‘Dr C Bravado’ stand for in a CTG?

A

Dr - define risk
C - contractions

Bra - baseline rate
V - variability
A - acceleration
D - deceleration

O - overall

… normal … non-reassuring …. pathological

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4
Q

What is a normal baseline foetal heart rate on a CTG?

A

110-160bpm

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5
Q

What is normal amount of variability in foetal heart rate?

A

> 5bpm

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6
Q

When is there sometimes less variability in foetal heart rate?

A

when they’re asleep!

but this shouldnt last more than 90mins

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7
Q

Should acceleration be present on CTG?

A

yes

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8
Q

Should deceleration be present on CTG?

A

early decels are normal
varibale decels are non-reassuring
late decels are pathological

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9
Q

What do you worry about if there’s late decels on CTG?

A

placental insufficiency

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10
Q

Which is more invasive but more effectives - scalp ECG or abdo ECG?

A

scalp ECG more invasive but more effective - don’t have to go through layers of abdo

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11
Q

What else does CTG show except from foetal heart rate?

A

uterine contractions

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12
Q

When does the first stage of labour end?

A

when cervix is fully effaced and dilated

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13
Q

When does second stage of labour end?

A

with birth of babby!

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14
Q

When does third stage of labour end?

A

with delivery of placenta

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15
Q

What are three parts of the first stage of labour?

A
  1. latent
  2. active
  3. transition
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16
Q

A woman is having irregular contractions, lasting around 30 seconds each, with mucoid show. She is 2cm dilated. What stage in she in?

A

first stage - latent (0-3cm)

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17
Q

A woman is having regular contractions, lasting 1 min each, 5cm dilated. What stage is she in?

A

first stage - active (3-7cm)

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18
Q

A woman is having INTENSE contractions, lasting 2 mins and running into each other. She is screaming “I’m gonna die”. Her waters have broken and she is 9cm dilated. What stage is she in?

A

first stage - transition (7-10cm)

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19
Q

Which stage of labour is the pushing stage, when the head comes through the pelvis?

A

second stage

20
Q

Which foetal lie is ideal?

A

longitudinal

21
Q

What is foetal station?

A

presenting part in relation to ischial spines. (a.k.a degree of descent)

22
Q

What is foetal engagement?

A

head in pelvis (5/5 engaged = head fully in)

23
Q

When should you “now pant, Maureen. Pant”

A

crowning (so don’t tear)

24
Q

What position should baby be in when coming out?

A 
face down
(occipito-anterior)
25
Q

What is waters breaking?

A

amniotic sac rupturing

26
Q

Describe what happens in the third stage of labour.

A

uterus contracts
placenta separates from wall
placenta delivered

27
Q

When is the window of implantation?

A

day 20-24

28
Q

In what situation does Rhesus disease happen?

A

Rhesus neg sensitized mum attacks Rhesus pos baby

29
Q

In rhesus disease, rhesus neg sensitized mum attacks Rhesus pos baby. What does this cause for the foetus?

A

haemolysis - anaemia

30
Q

Who do you give anti-D prophylaxis to?

A

all rhesus negative pregnant women

31
Q

Name non pharma management of labour pain

A

hydrotherapy
massage
TENS (transcutaneous electrical nerve stimulation)

32
Q

Analgesia in labour can be systemic or regional. Name two systemic and two regional.

A

systemic:
IM pethidine
Entonox

regional:
epidural
spinal

33
Q

where does spinal cord end?

A

L1/2

34
Q

Where do you go in for epidural?

A

L3/4 (btw iliac crests)

35
Q

What are two problems with epidural?

A

best pain relief but may prolong labour and raise mother’s temp.

36
Q

How is spinal different to epidural?

A

go THROUGH dura into CSF to make completely numb fast (intra-thecal)

37
Q

When do you use spinal anaesthetic?

A

only for defined period e.g. before elective Caesarean (cant leave cath in, dont want CSF infection)

38
Q

With general anaesthetic - what is one danger to mother and one danger to baby?

A

mother - aspiration gastric contents

baby - risk of anaesthetising baby

39
Q

Give me some examples of when sensitization culd happen (foetal and mum’s blood mixing)?

A

abdo trauma
APH
amniocentesis / invasive procedures

40
Q

When is booking appointment?

A

8-12wks

41
Q

When is dating scan? What else happens at dating scan as well as dating?

A

12 wks

screening for trisomy 13 (patau’s), 18, 21.

42
Q

When is first trimester?

A

conception - 12wks

43
Q

When is second trimester?

A

13wks - 27wks

44
Q

When is third trimester?

A

28wks - 41wks

45
Q

How long does each trimester roughly last?

A

3 months

46
Q

When is the anomaly scan?

A

20wks

47
Q

Midwifery check, birth planning and education appointment. When is this?

A

34wks

Obstetrics (6 decks)

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