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Year 3 - Repro and Sexual Health > Labour > Flashcards

Labour Flashcards

1
Q

Within how long should an emergency C-sec take place from threat to mother or baby’s life?

A

30mins

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2
Q

What are the 2 most common reasons to perform emergency C-sec?

A

Failure to progress

Suspected/confirmed foetal compromise

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3
Q

What are H2 receptor antagonists used for in C-sec?

A

Prevent Mendelson’s syndrome

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4
Q

What is Mendelson’s syndrome?

A

Aspiration of gastric contents into the lung

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5
Q

Which anaesthetic options can be used in C-sec?

A

Epidural
Spinal
GA

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6
Q

What layers are incised during C-sec?

A 
Skin
Camper's fascia
Scarpa's fascia
Rectus sheath
Rectus muscle
Abdominal peritoneum
Visceral peritoneum
Uterus
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7
Q

C-sec carries in increases risk of uterovaginal prolapse, neonatal infection and perineal trauma true/false

A

False

It is lower risk for all of these as well as incontinence and later still birth

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8
Q

Give indications for induction of labour?

A

Prolonged gestation
Premature membrane rupture
Maternal health problems (pre-eclampsia, DM)
Foetal growth restriction

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9
Q

What is the management of preterm rupture of membranes >37 weeks gestation?

A

Expectant waiting for 24 hours and then induction

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10
Q

What is the management of rupture of membranes <34 weeks gestation?

A

Delay labour induction unless there are other negative factors

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11
Q

What are the absolute contraindications to induction of labour?

A 
Major PP
VP
Cord prolapse
Transverse lie
Active genital herpes
Prev C-sec
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12
Q

What are relative contraindications to C-sec?

A

Breech presentation
Triplets (or more !!)
2+ previous low transverse C-sec

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13
Q

What are the three main methods of labour induction?

A

Vaginal prostaglandins
Amniotomy
Membrane sweep

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14
Q

How do vaginal prostaglandins induce labour?

A

Ripen the cervix

Stimulate contraction of sm of uterus

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15
Q

What is an amniotomy?

A

Artificial rupture of membranes with amniohook

Causes prostaglandin release

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16
Q

What is a membrane sweep?

A

Insert gloved finger to “sweep” around foetal membranes to separate them from the decidua

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17
Q

What does the Bishop score assess?

A

Cervical ripeness

18
Q

What Bishop score indicates induction of labour is possible?

A

> =7

19
Q

How is foetus monitored if oxytocin given during labour?

A

CTG

20
Q

What is an operative vaginal delivery?

A

Use of instrument to aid delivery of the uterus

21
Q

What are the two main instruments used in operative delivery?

A

Ventouse

Forceps

22
Q

What is a ventouse?

A

Instrument used which attaches at the foetal head with vaccuum

23
Q

What are the two most common types of ventouse?

A

Kiwi

Silastic cup

24
Q

In which foetal position may a silastic cup be used?

A

OA

25
Q

How is a forceps delivery carried out?

A

Blades applied to either side of the head and gentle traction applied in time with contractions

26
Q

Which forceps type is used a C-sec?

A

Wrigley’s

27
Q

Which type of forceps is used for rotational delivery?

A

Klielland;s

28
Q

Which maternal factors would be an indication for operative delivery?

A 
Inadequate progress (2hrs nulliparous, 1hr multiparous)
Maternal exhaustion
Congenital heart disease
HTN
Intracranial pathologies
29
Q

Which foetal factors would be indications for operative delivery?

A

Foetal compromise

APH

30
Q

Give examples of absolute contraindications to any operative delivery

A

Unengaged foetal head
Incompletely dilated cervix
(in single preg)
Breech presentation

31
Q

Give absolute contraindications for ventouse delivery?

A

Perterm

High likelihood of coag disorder

32
Q

Which foetal complications may arise from operative delivery?

A 
Scalp laceration
Bruising
Facial nerve damage
Skull fracture
Retinal haemorrahge
33
Q

Which maternal complications may arise as a result of operative delivery?

A 
Vaginal tear
VTE
Incontinence
PPH
Shoulder dystocia
Infection
34
Q

Define premature rupture of membranes

A

Rupture of membranes 1 hour prior to onset of labour >=37 weeks gestation

35
Q

Define pre-term premature rupture of membranes

A

Rupture <37 weeks gestation

36
Q

What do the foetal membranes consist of?

A

Chorion

Amnion

37
Q

How do the foetal membranes become weaker for labour?

A

Through apoptosis and enzyme-mediated collagen breakdown

38
Q

What are the three main causes of early membrane rupture?

A

Physiological early activation
Infection
Genetic predisposition

39
Q

What are the major risk factors for early membrane rupture?

A 
Smoking
Prev event
Vaginal bleeding
Invasice procedures
Multiple preg
Polyhydramnios
Cervical insuff
40
Q

Even if fluid can be seen leaking from vagina, speculum exam is required
true/false

A

False
Get woman to lay on back for 30mins - should see pooling of fluid
Ask to cough and amniotic fluid should come out

41
Q

What investigation should be performed in all early membrane rupture?

A

High vaginal swab

Year 3 - Repro and Sexual Health (23 decks)

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