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Y4R2 - Obstetrics I 🤰 > L4: Labor (Management) > Flashcards

L4: Labor (Management) Flashcards

1
Q

Managment of Labor

A
  • 1st stage
  • 2nd Stage
  • 3rd Stage
  • 4th Stage
  • Care of Newborn
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2
Q

Managment of Labor

  • 1st Stage
A
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3
Q

Management of 1st stage of Labor

  • Position
A
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4
Q

Management of 1st stage of Labor

  • Bearing Down?
A

No, To avoid exhaustion.

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5
Q

Management of 1st stage of Labor

  • Nutrition
A
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6
Q

Management of 1st stage of Labor

  • Bladder & Rectum
A
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7
Q

Management of 1st stage of Labor

  • Asepsis
A

Before any vaginal examination.

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8
Q

Management of 1st stage of Labor

  • Analgesia
A

Pethidine (50 mg) or morphine if labor isn’t expected in 3 hours.

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9
Q

Management of 1st stage of Labor

  • Vaginal Examination
A
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10
Q

Management of 1st stage of Labor

  • Time of Vaginal Examination
A

1) On admission: To ensure onset of labor.
2) After ROM: To exclude cord prolapse.
3) Every 2 hours: To assess progress of labor.

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11
Q

Management of 1st stage of Labor

  • Aim of Vaginal Examination
A
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12
Q

Management of 1st stage of Labor

  • Monitoring of Labor
A
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13
Q

Management of 2nd stage of Labor

A
  • Before Head Delivery
  • Head Delivery
  • After Head Delivery
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14
Q

Management of 2nd stage of Labor

  • Before Head Delivery
A
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15
Q

Management of 2nd stage of Labor

  • position
A

Lithotomy position on delivery table.

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16
Q

Management of 2nd stage of Labor

  • Sterialization & Towelling
A

…

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17
Q

Management of 2nd stage of Labor

  • Evacuation
A

Evacuation of bladder & rectum.

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18
Q

Management of 2nd stage of Labor

  • Bearing Down?
A

Ask patient to bear down during uterine contractions only & relaxes () contractions.

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19
Q

Management of 2nd stage of Labor

  • Observation
A

Observations for maternal & fetal conditions.

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20
Q

Management of 2nd stage of Labor

  • Head Delivery
A
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21
Q

Aim in Head delivery

A

Decrease Perineal Lacerations

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22
Q

Head delivery

  • When to support Perineum?
A

As soon as head distends vulva, attendant supports perineum by closed fist of hand & pad of cotton

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23
Q

Head delivery

  • Why Support The Perineum?
A

to maintain flexion of head till crowning occurs (to ensure distension of vulva by the smallest diameter of fetal head).

24
Q

Head delivery

  • Managment of Head Extension
A
  • If extension occurred before crowning (premature extension) → Increased diameter distending vulva → perineal tear.
  • After crowning, head is allowed to extend in () uterine contractions (not during uterine contractions) by Ritgen ‘s maneuver which means upward & backward pressure on perineum & downward pressure on occiput to allow gradual extension of head.
25
Q

Head delivery

  • After Crowning
A
  • After crowning, head is allowed to extend in () uterine contractions (not during uterine contractions) by Ritgen ‘s maneuver
  • Which means upward & backward pressure on perineum & downward pressure on occiput to allow gradual extension of head.
26
Q

Head delivery

  • Episiotomy
A

Episiotomy is done è crowning when it is indicated.

27
Q

Management of 2nd stage of Labor

  • After Delivery of Head
A
28
Q

Management of 2nd stage of Labor

  • Swabbing
A

Baby’s eyelids, mouth & nose are swabbed.

29
Q

Management of 2nd stage of Labor

  • Suction
A

Suction is done to clear airway starting by mouth then nose.

30
Q

Management of 2nd stage of Labor

  • Examination of Cord
A
  • Examination for any loop of cord coiled around neck: If coils of cord are present, do either slipping of coil or division of cord if tight) in () 2 clamps.
31
Q

Management of 2nd stage of Labor

  • Delivery of Shoulders
A
32
Q

Management of 2nd stage of Labor

  • Delivery of Trunk & rest
A

Easily

33
Q

Management of 2nd stage of Labor

  • Holding Newborn
A
  • Newborn is held from his feet è head down for few seconds to drain respiratory passage
34
Q

Management of 2nd stage of Labor

  • When to avoid Holding Newborns in upside down way?
A

Except in cases of

  • Prematurity
  • Asphyxia
  • Possibility for ICH
35
Q

Management of 2nd stage of Labor

  • Ligation & Cutting of Cord
A
36
Q

Management of 2nd stage of Labor

  • When to avoid milking Cord?
A

Cord is clamped immediately eout milking in the following conditions:

  • Premature baby: To avoid hypervolemia, HF & hyperbilirubinemia.
  • Rh isoimmunization: To Decrease Abs reaching neonate.
  • Diabetic mother: To avoid hypervolemia.
  • Multifetal pregnancy.
  • After general anesthesia: To anesthetic agents & get early recovery.
37
Q

Management of 2nd stage of Labor

  • Inspection of Lower Genital Tract & Perineum
A

For lacerations & tears.

38
Q

Managment of 3rd stage of Labor

A
39
Q

Managment of 3rd stage of Labor

  • Aims
A

1) Ensuring complete expulsion of placenta & membranes.
2) Prevention of PPH.

40
Q

Managment of 3rd stage of Labor

  • Methods
A
  • Conservative
  • Active
41
Q

Expectant Managment of 3rd stage of Labor

  • Method
A
42
Q

Expectant Managment of 3rd stage of Labor

  • Advantages
A

Safe

43
Q

Expectant Managment of 3rd stage of Labor

  • Disadvantages
A

Time consuming & more blood loss.

44
Q

Active Managment of 3rd stage of Labor

  • Method
A
45
Q

Active Managment of 3rd stage of Labor

  • Advantages
A

Decrease duration of 3rd stage —-> Decrease blood loss —–> decrease incidence of PPH.

46
Q

Active Managment of 3rd stage of Labor

  • Disadvantages
A
47
Q

Managment of 4th stage of Labor

A

Observation for 1 hour for PPH.

48
Q

Neonatal Care After Labor

A
49
Q

Neonatal Care After Labor

  • Apgar Score
A

Done routinely at 1 & 5 minutes after delivery.

50
Q

Neonatal Care After Labor

  • Bathing
A

To clean neonate from blood & vernix caseosa.

51
Q

Neonatal Care After Labor

  • Clear Respiratory Tract
A

Head low down 15° & resuction to remove mucus.

52
Q

Neonatal Care After Labor

  • Umbilical Stump
A
  • Cord is ligated (by 2 silk ligatures) or clamped (by plastic sterile clamp) 5 cm from umbilicus (to avoid tying any hernia protruding in cord).
  • Paint cut end of cord è alcohol & cover it by sterile bandage.
53
Q

Neonatal Care After Labor

  • Position
A
  • Put neonate on rigid flat table under radian heat from above (to avoid chills. & hypothermia).
54
Q

Neonatal Care After Labor

  • Weighing
A

of the baby

55
Q

Neonatal Care After Labor

  • Marking
A

to avoid loss

56
Q

Neonatal Care After Labor

  • Examination
A

Examination for sex & congenital anomalies.

57
Q

Neonatal Care After Labor

  • Eyes
A

Give antibiotic or antiseptic eye drops to avoid ophthalmia neonatorum.

Y4R2 - Obstetrics I 🤰 (52 decks)

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