Keppler - 4 Flashcards
4 types of malpresentation
breech
transverse
compound
face or brow
3 types of breech
complete
flank
incomplete/footing
what is transverse breech
back up vs down
management of cephalic malpresentation
external cephalic version
why do we like external cephalic version
better chance of vaginal delivery
4 contraindications to external cephalic version
non-reassuring fetal status
fetal anomalies
not a singleton pregnancy
cesarean indicated
late-term pregnancy definition
41-42 weeks
post-term pregnancy definition
42+ weeks
NST categories
I-III
baseline (reactive) NST category
I
when do we worry about NST findings
anything after I
what does VBAC stand for
vaginal birth after cesarean
candidates for VBAC
1-2 prior cesareans
known (or assumed) low transverse uterine scar
no other prior uterine surgery
no contraindication to vaginal delivery
obstetrician and anesthesia in house
why do we care about cesarean scar
1 in 400 chance scar could rip open and mom could hemorrhage → permanent harm to baby
problem w. cesarean
higher risk to mom
problem w. VBAC
higher risk to baby
the risk of shoulder dystocia rises w.
size of baby
change in cervical dilation or fetal station that is slower than predicted or stopped altogether
abnormal labor
3 p’s
power
passenger
pelvis
procedure to manually rotate fetal body into a position compatible w. vaginal delivery
external cephalic version (ECV)
post-term pregnancy definition
any pregnancy beyond 40 weeks gestation
post term pregnancy is associated w. (3)
fetal heart rate abnormalities
abnormal labor
cesarean
what is used to assess fetal oxygenation in labor
continuous fetal
__
and __ suggest temporary or chronic fetal hypoxia
pathologic decels
VBAC decreases __ risks
maternal risks
failure of passage of presenting shoulder under the maternal pubic symphysis
shoulder dystocia
risks of shoulder dystocia
hypoxia
death
