Intrapartum Care Flashcards
What do you eat during labour?
Light diet during early labour
Clear fluids afterwards
When do you give abx in labour?
GBS positive
Prolonged ruptured membranes
Suspected chorio-amnionitis
Endocarditis prophylaxis
What is the carriage rate of GBS? What are the rates of complications?
20%
1 in 200 carriers serious fetal infection
1 in 5 fetal infection death or permanent disability
How do you screen for GBS?
Low vaginal and anal swab
What abx do you give in GBS?
Intrapartum peni
Clindamycin or erythromycin if penicillin insensitive
What are some effective non-pharmacological technique?
Support person
TENS
What are the pharmacological approaches?
NO
Narcotic analgesia
Regional analgesia
What does the pain come from in labour?
Dilation of the cervix
Which narcotics are used?
Morphine - 10mg 3-4 hourly
Fentanyl - IV infusion
Pethidine - 100mg 3-4 hourly
What are the downsides of narcotics? How do you combat it?
Nausea
- metoclopramide, prochlorperazine
How do you reverse respiratory depression?
Naloxone - caution it wearing off prior to narcotic wearing off - must be observed for 4 hours
Why don’t narcotics work?
The pain is intermittent - doesn’t cover the intense pain at the peak, only takes the edge off
Where do spinals go?
Subarachnoid space
What are some contraindications for regional analgesia?
Absolute
- Allergy to local anaesthetics
- Infection at site
Relative
- Coagulopathy
- Systemic infection
Which agents are used in regionals?
Lignocaine
