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Reproductive > Labour > Flashcards

Labour Flashcards

1
Q

What is labour?

A

A physiological process in which the foetus, membranes, umbilical cord and placenta are expelled from the uterus.

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2
Q

What hormones are involved in labour?

A

Progesterone
Oestrogen
Oxytocin

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3
Q

What is crucial in allowing the cervix to dilate?

A

Cervical softening

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4
Q

When does the 2nd stage of labour begin?

A

When the cervix is fully dilated.

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5
Q

What is the best shape of pelvis to aid delivery of a foetus?

A

Gynaecoid

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6
Q

Is the diameter of the pelvic inlet the same as the pelvic outlet?

A

No

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7
Q

What is expulsed from the vagina first during delivery?

A

Head and then the anterior shoulder of the foetus.

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8
Q

Should clamping of the umbilical cord be carried out ASAP?

A

No, delay of this maximises the RBC supply at birth.

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9
Q

For how long is skin-to-skin contact recommended following birth?

A

Atleast an hour.

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10
Q

What can be given to aid expulsion of the placenta in the 3rd stage of pregnancy?

A

Syntometerine

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11
Q

What is a normal amount of blood to lose during pregnancy?

A

Around 500ml.

If over 1 litre - this is bad.

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12
Q

What is the puerperium?

A

The period of recovery and repair following pregnancy.

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13
Q

What is defined as preterm labour?

A

That occurring prior to 37 weeks gestation.

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14
Q

What is defined as post-term labour?

A

That occurring after 42 weeks gestation.

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15
Q

What is the most effective anaesthesia available in pregnancy?

A

Epidural

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16
Q

How is progression of labour assessed?

A

Cervical dilatation
Descent of the presenting part
Monitoring for signs of obstruction

17
Q

What is the expected rate of progression during labour?

A

2cm every 4 hours.

18
Q

What is the most common reason for failure to progress during labour?

A

Deflexion of the foetal head.

19
Q

What is a partogram?

A

A graphic representation of labour progress.

20
Q

What is post-partum haemorrhage?

A

Any blood loss > 500ml in the 24 hours following birth.

21
Q

When is a PPH described as a major PPH?

A

If 1000ml of blood is lost.

22
Q

At what % blood loss does BP begin to drop?

A

Over 30%.

This is a late sign.

23
Q

What are the 4 ‘T’s responsible for PPH?

A

Tone
Trauma
Tissue
Thrombin

24
Q

What is the most common cause of PPH?

A

Uterine atony

Uterus fails to contract down following labour. This results in vessels remaining open, therefore bleeding occurs.

25
Q

How is PPH managed?

A

‘ABCDE’
Uterotonic drugs
Tranexamic acid

26
Q

What are examples of uterotonic drugs?

A

Oxytocin
Ergometrine
Carboprost
Misoprostol

27
Q

What is the action of uterotonic agents?

A

To initiate uterine contraction.

28
Q

What is the first-line surgical management of PPH?

A

Intrauterine balloon

29
Q

What is a complication of a morbidly adherent placenta?

A

Uterine inversion - can lead to prolapse.

This is an obstetric emergency.

30
Q

What is shoulder dystocia?

A

When the shoulders of the foetus do not pass following the head, becoming wedged behind the mother’s pubic symphysis.

31
Q

What may result from shoulder dystocia?

A

Irreversible injury to the brachial plexus.

32
Q

Is genital tract trauma common in pregnancy?

A

Yes, occurs in 95% of first-time mothers.

33
Q

What is the most common cause of post-partum sepsis?

A

Infection of the uterus (called endometritis).

34
Q

what are risk-factors for post-partum sepsis?

A

Prolonged rupture of membranes
Use of instruments during labour
Tissue left within the womb following delivery

35
Q

how is sepsis managed?

A 
Give O2, keep sats >94%
Take blood culture
Give IV antibiotics (usually co-amoxiclav)
Give fluid challenge
Measure lactate
Measure urine output

Think sepsis ‘6’.

36
Q

In those with a penicillin allergy, what is given instead of co-amoxiclav in the treatment of sepsis?

A

Clindamycin and gentamicin.

Both given intravenously.

Reproductive (28 decks)

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