Intrapartum Flashcards
What is the rate of OVD in UK
10-13%
What are the requirements for OVD
- examination
- head is <= 1/5th palpable
- vertex presentation
- cervix fully dilated and membranes ruptured
- position of head known
- assess for caput and molding
- adequate pelvis
What are the requirements for OVD
- Maternal preparation
- explanation and verbal consent
- analgesia (if midcavity eg pudendal block)
- Urinary catheter (bulb deflated)
What percentage of CS are done at full dilatation
4-5%
What is the risk of intraoperative trauma of full dilation vs 1st stage CS
> double the risk
Risk of haemorrhage
Full dilation vs first stage CS
4.7-10% vs 2.9%
Approx 2-3×increased
Risk of perinatal asphyxia
Full dilatation vs first stage CS
1.5 times increased
Risk of SCN admission
Full dilation vs OVD
11% vs 6%
Risk of maternal haemorrhage
Full dilation vs OVD
4.7-10% vs 3%
Up to 3times higher
Benefits of CS at full dilatation
-less long term and short term Urinary incontinence
- less neonatal trauma
What are the branches of the pudendal nerve
- dorsal nerve of clitoris
- inferior rectal
- perineal nerve
What muscles are innervated by the branches of the pudendal nerve
- bulbospongiosus
- ischiocavernosus
- levator Ani group
- external anal spinchter
- external urethral spinchter
Contraindications to carbegoline
- pre eclampsia
- cardiac valvulopathy
- pericardial/pulmonary/retroperitoneal fibrosis
- puerperal psychosis
- ergot alkaloid hypersensitivity (ergometrine)
What suction pressure is used for the vacuum
80kPa
Risk of EOGBS if intrapartum fever
5.3:1000
