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Clinical: Woman's Health > Labor and Delivery Complications > Flashcards

Labor and Delivery Complications Flashcards

1
Q

what is the treatment for breech presentation

A

external cephalic version at or near term
followed by a trial of a vaginal delivery if the version is successful and planned cesaarean delivery if breech presentation persists

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2
Q

what is dystocia

A

obstructed labor, aka labor dystocia.
when the baby does not exit the pelvis during childbirth due to being physically blocked, despite the uterus contracting normally

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3
Q

how is dystocia defined

A

abnormal labor progression

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4
Q

what are different categories of dystocia

A

problems of power
problems of passenger
problems of passage

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5
Q

what is problems of power

A

uterine contraction issues

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6
Q

what is problems of passenger

A

presentation, size (macrosomia), or position of the fetus (shoulder dystocia)

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7
Q

wha tis problems of passage

A

uterus or soft tissue abnormalities

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8
Q

what is shoulder dystocia

A

failure of the shoulders to deliver spontaneously after delivery of the fetal head
- obstetric emergency

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9
Q

what is turtle sign

A

retraction of the delivered head against the maternal perineum

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10
Q

what is the treatment for dystocia

A

before considering surgical options, change the posture of the mother during labor can help to progress labor
- c-section or vacuum extraction may be necessary

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11
Q

what are treatment options for shoulder dystocia

A

non-manipulative maneuvers (first line)
- suprapubic pressure, flexion of maternal hips
manipulative maneuvers
- rotation of fetal shoulders 180 degrees, delivery of poterior arm
emergency cesarean section

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12
Q

what is mcroberts maneuver

A

flexion of maternal hips for shoulder dystocia presentation

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13
Q

what is woods’corkscrew

A

rotation of fetal shoulders 180 degrees for shoulder dystocia

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14
Q

what is the zavanelli maneuver

A

pushing fetal head back into vaginal canal with immediate transport to cesarean section

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15
Q

what is considered fetal tachycardia

A

HR > 160 for 10 minutes

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16
Q

what is considered fetal bradycardia

A

HR < 120 for 10 minutes

17
Q

what is the clinical definition of PROM

A

rupture of membranes prior to 27 weeks gestation prior to the start of uterine contractions

18
Q

what is PPROM

A

preterm premature rupture of membranes - < 37 weeks gestation

19
Q

what are risks of PROM

A

infection or cord prolapse

20
Q

what are s/sx of PROM

A

sudden “gush” of clear or pale yellowish fluid from vagina that occurs after 37 weeks of gestation

21
Q

how is PROM diagnosed

A

confirmation of amniotic fluid - Nitrazine test (blue)
microscopic “fern pattern”

22
Q

what is the treatment of PROM

A

> 34 weeks - induce labor
32-34 weeks collect fluid and check for lung maturity - then induce
< 32 weeks stop contractions and start 2 doses of steroid injection then deliver the baby - give abx

23
Q

what is the definition of preterm delivery?

A

delivery of a viable infant before 37 weeks gestation

24
Q

how is preterm labor diagnosed

A

fetal fibronectin in cervical or vaginal secretions
placental alpha microglobulin (PAMG-1)
obstetric US

25
Q

what is the treatment of preterm labor

A

tocolysis - number of meds may be used to delay delivery including NSAIDs, CCB, beta mimetics and atosiban

26
Q

what is the use of Tocolytics

A

helps to relax uterus and are used in the tx of preterm labor

27
Q

a 32-year-old G1P1 who you are monitoring on the obstetrics ward as part of your clinical rotation is progressing well when you begin to note a sudden and severe decrease in fetal heart rate that does not immediately resolve. On fetal heart tracing, you note moderate to severe variable decelerations.
what is the moste likely diagnosis

A

prolapsed umbilical cord

28
Q

what can prolapsed umbilical cord lead to

A

fetal hypoxia
brain damage
and death

29
Q

what is the treatment of prolapsed umbilical cord

A

immediate cesarean section

Clinical: Woman's Health (12 decks)

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