Labour

Question 1

What is the normal variability on a fetal CTG?

Answer 1

5-15bmp

Question 2

What can early and late decelerations indicate on CTG?

Answer 2

Early - innocuous, or head compression

Late- foetal distress eg asphyxia or placental insufficiency

Question 3

What is the stepwise management for uterine atony and PPH?

Answer 3

• uterine massage
• IV syntoninon (5U) and then ergometrine (0.5mg)
• 40U syntocin
• IM carboprost (0.25mg)
• consider b-lynch, balloon tamponade, ligation of arteries.

Question 4

What is the most common explanation for lack of variability for short periods on the CTG?

Answer 4

Sleeping

>40mins start to worry - drugs, acidosis,premAturity
>90 abnormal

Question 5

In a normal uncomplicated labour, now often should you monitor contractions and fetal heart rate?

Answer 5

Every 15 mins in first stage

Every 5 mins through 2nd stage

Question 6

How to differentiate between vasa and placental praevia?

Answer 6

Vasa- rupture of membranes then bleeding and Brady cardia

Placenta- painless vaginal bleeding, often seen on ultrasound

Question 7

How do you manage breech presentation in labour?

Answer 7

C- section (can be vaginal but less reccommended)

External cephalic version needs to be done at 36 weeks

Question 8

What’s the bishops score?

Answer 8

Position, consistency, effacement, dilation, station

Score 5/14 induction will be needed (PG)