Labour Flashcards

1
Q

What is the 1st stage of labour?

A

Progressive contractions with thinning of cervix and dilatation from 3-10cm

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2
Q

What is the second stage of labour?

A

Full dilation to delivery where head descends down pelvis

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3
Q

What is the third stage of labour?

A

From delivery of baby to delivery of placenta and membranes within 30 minutes of baby delivery

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4
Q

What can be given after delivery of the anterior shoulder to deliver placenta?

A

Oxytocin injection

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5
Q

What are 2 non-regional analgesia options for labour?

A

Entonox (gas and air)
IM morphine

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6
Q

What is a regional analgesic for labour?

A

Epidural into L3-4

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7
Q

What are some indications for induction of labour?

A

Pregnancy over 41 weeks
PROM
Maternal request
Maternal health - pre-eclampsia

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8
Q

What is an induction method offered from 39 weeks?

A

Membrane sweep

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9
Q

What is an induction method for bishop score over 6?

A

Amniotomy - artificial ROM

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10
Q

What is defined as a delay for the first stage of labour?

A

Cervical dilatation of less than 2cm in 4 hours

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11
Q

What is defined as a delay for the second stage of labour?

A

Nulliparous> 2 hours
Multiparous > 1 hour

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12
Q

What are the 3 P’s of delayed labour?

A

Power
Passenger
Passage

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13
Q

What are the 3 elements of passenger?

A

Size of foetus - head and shoulder diameter
Foetal presentation - cephalic, brow, breech
Foetal position

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14
Q

What can be given to speed up labour?

A

Oxytocin infusion

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15
Q

What is shoulder dystocia?

A

Anterior shoulder gets stuck behind pubic symphysis

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16
Q

What can shoulder dystocia cause?

A

Brachial plexus injury - Erb’s palsy or Kulmpke’s palsy

17
Q

What are some risk factors for shoulder dystocia?

A

Macrosomia
Maternal DM
High maternal BMI
Prolonged labour

18
Q

What is the turtle neck sign?

A

Head retracts into birth canal

19
Q

What is the 1st line management for shoulder dystocia?

A

McRober’s manoeuvre
Suprapubic pressure
Discourage pushing

20
Q

What is a cleidotomy?

A

Clavicles are cut to reduce diameter

21
Q

What is a CTG?

A

Used to measure foetal heart rate and uterus contractions

22
Q

What are some indications for continuous monitoring?

A

Sepsis
Maternal tachycardia
Significant meconium
Labour delayed
Pre-eclampsia

23
Q

What are 5 things a CTG measures?

A

Contractions
Baseline HR
Variability
Accelerations
Decelerations