Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obs and Gynae > Labour and delivery > Flashcards

Labour and delivery Flashcards

1
Q

What are the 3 stages of labour?

A

First stage - from the onset of labour (true contractions) until 10cm cervical dilatation
Second stage - from 10cm cervical dilatation until delivery of the baby
Third stage - from delivery of the baby until delivery of the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 phases of stage 1 labour?

A

involves cervical dilation and effacement (getting thinner).
The “show = mucus plug in the cervix, which prevents bacteria from entering the uterus during pregnancy, falling out and creating space for the baby to pass through

Latent phase - from 0 to 3cm dilation of the cervix. This progresses at around 0.5cm per hour. There are irregular contractions.
Active phase - from 3cm to 7cm dilation of the cervix. This progresses at around 1cm per hour, and there are regular contractions.
Transition phase - from 7cm to 10cm dilation of the cervix. This progresses at around 1cm per hour, and there are strong and regular contractions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 signs of labour

A

Show (mucus plug from the cervix)
Rupture of membranes
Regular, painful contractions
Dilating cervix on examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

difference between latent 1st stage and established 1st stage of labour

A

The latent first stage is when there are both:
Painful contractions
Changes to the cervix, with effacement and dilation up to 4cm

The established first stage of labour is when there are both:
Regular, painful contractions
Dilatation of the cervix from 4cm onwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

3 classes of prematurity

A

Under 28 weeks: extreme preterm
28 - 32 weeks: very preterm
32 - 37 weeks: moderate to late preterm

Babies are considered non-viable below 23 weeks gestation
Jesus baby if ≥24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how can you prevent preterm labour

A

vaginal progesterone

cervical cerclage - stich in cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how is vaginal progesterone useful to prevent preterm labour?

A

role: maintain pregnancy and prevent labour by decreasing activity of the myometrium and prevent the cervix remodelling in preparation for delivery.

This is offered to women with a cervical length <25mm on vaginal US 16-24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is cervical cerclage useful to prevent preterm labour?

A

stitch in cervix to add support, keep it closed
under GA or spinal
remove stitch when in labour or reaches term

This is offered to women with a cervical length <25mm on vaginal US 16-24 weeks WHO HAVE had previous pre-term birth or cervical trauma (colposcopy, cone biopsy)

“Rescue” cervical cerclage may also be offered between 16- 27 + 6 weeks when there is cervical dilatation without rupture of membranes, to prevent progression and premature delivery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do you if woman has ruptured her membranes (amniotic sac)?

A

speculum –>pooling of amniotic fluid in the vagina. No tests are required.

If doubt:

  • Insulin-like growth factor-binding protein-1 (IGFBP-1) = a protein present in high conc in amniotic fluid, which can be tested on vaginal fluid
  • Placental alpha-microglobin-1 (PAMG-1) is a similar alternative to IGFBP-1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how do you manage PPROM?

A

Preterm prelabour rupture of membranes is where the amniotic sac ruptures, releasing amniotic fluid, before the onset of labour and in a preterm pregnancy

Prophylactic antibiotics –> prevent chorioamnionitis.
- erythromycin 250mg TDS for 10/7 or until labour is established (if within 10 days)

Induction of labour may be offered from 34 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is fetal fibronectin used to diagnose?

A

Preterm labour
alternative test to vaginal ultrasound.
Fetal fibronectin is the “glue” between the chorion and the uterus, and is found in the vagina during labour.
<50 ng/ml is considered negative, and indicates that preterm labour is unlikely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

5 methods of improving outcomes in preterm labour

A
  1. Fetal monitoring (CTG or intermittent auscultation)
  2. Tocolysis with nifedipine: nifedipine is a CCB that suppresses labour
  3. Maternal corticosteroids: can be offered <35 weeks gestation to reduce neonatal morbidity and mortality
  4. IV magnesium sulphate: can be given <34 weeks gestation and helps protect the baby’s brain
  5. Delayed cord clamping or cord milking: can increase the circulating blood volume and haemoglobin in the baby at birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what medication causes tocolysis?

A

nifedipine - CCB
used to stop uterine contractions

aosiban = oxytocin R antagonist, for when if is CI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when can tocolysis be used?

A

used to stop uterine contractions (Pre-term)

used 24-34 weeks in preterm labour to delay delivery
only use <48 hours
also administer maternal steroids, transfer to specialist unit with NICU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why are maternal steroids given in premature labour?

A

helps to develop the fetal lungs and reduce respiratory distress syndrome after delivery.

used <36 weeks gestation.
regime: 2 doses IM
betamethasone, 24 hours apart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is IV MAGNESIUM SULFATE given to mother in premature labour?

A

protects fatal brain in premature delivery
dec risk and severity of cerebral palsy
give within 24 hours of delivery of PTB <34 weeks
give a bolus, then infusion for 24 hours or until birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do you monitor for magnesium toxicity in treatment of PTB?

A

Mothers need close monitoring for magnesium toxicity at least four hourly. This involves close monitoring of observations, as well as tendon reflexes (usually patella reflex).

Key signs of toxicity are:
Reduced respiratory rate
Reduced blood pressure
Absent reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when is induction of labour offered?

A

41 - 42 weeks

Prelabour rupture of membranes
Fetal growth restriction
Pre-eclampsia
Obstetric cholestasis
Existing diabetes
Intrauterine fetal death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the Bishop score?

A

used to determine wether to induce labour

min score 0 ,max 13
<8 suggests cervical ripening may be req to prepare cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what 5 things are assessed on bishop score?

A

5 things are assessed and given a score based on different criteria (minimum score is 0 and maximum is 13):

Fetal station (scored 0 - 3)
Cervical position (scored 0 - 2)
Cervical dilatation (scored 0 - 3)
Cervical effacement (scored 0 - 3)
Cervical consistency (scored 0 - 2)

A score of ≥ 8 predicts a successful induction of labour.
<8 suggests cervical ripening may be required to prepare the cervix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

5 options to induce labour

A
  1. membrane sweep (adjunct only)
  2. vaginal prostaglandins
  3. cervical ripening balloon CRB
  4. artificial rupture of membranes with oxytocin infusion
  5. oral mifepristone + misoprostol (intrauterine fetal death)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what 2 things do you monitor when induce labour?

A

Cardiotocography (CTG) to assess the fetal heart rate and uterine contractions before and during induction of labour

Bishop score before and during induction of labour to monitor the progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the main complication of induction of labour?

A

uterine hyperstimulation

- contraction of the uterus is prolonged and frequent –> causes fetal distress and compromise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

2 criteria for uterine hyperstimulation

A
  1. Individual uterine contractions lasting > 2 minutes in duration
  2. > 5 uterine contractions every 10 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

3 consequences of uterine hyperstimulation

A
  1. Fetal compromise, with hypoxia and acidosis
  2. Emergency caesarean section
  3. Uterine rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

management of uterine hyperstimulation

A

Removing the vaginal prostaglandins, or stopping the oxytocin infusion
Tocolysis with terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Indications for Continuous CTG Monitoring in labour

A 
Sepsis
Maternal tachycardia (> 120)
Significant meconium
Pre-eclampsia (particularly blood pressure > 160 / 110)
Fresh antepartum haemorrhage
Delay in labour
Use of oxytocin
Disproportionate maternal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

5 key features on CTG

A
  1. Contractions - the number of uterine contractions per 10 minutes
  2. Baseline rate - the baseline fetal heart rate
  3. Variability - how the fetal heart rate varies up and down around the baseline
  4. Accelerations - periods where the fetal heart rate spikes
  5. Decelerations - periods where the fetal heart rate drops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is a good sign on CTG?

A

Accelerations (periods where the fetal heart rate spikes) are generally a good sign that the fetus is healthy, particularly when occurring alongside contractions of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

3 words to classify baseline rate and variability on CTG

A

reassuring, non-reassuring and abnormal

BLR reassuring 110-160
VAR reassuring 5-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is a concerning sign on CTG?

A

decelerations
fetal HR drops in response to hypoxia (to save O2 for vital organs)

4 types:
Early decelerations
Late decelerations
Variable decelerations
Prolonged decelerations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are Early decelerations on CTG?

A

gradual dips and recoveries in HR, correspond with uterine contractions.
lowest point of the declaration corresponds to the peak of the contraction.

Normal, not pathological.
Caused by the uterus compressing the head of the fetus –> stimulae the vagus nerve of the fetus, slowing the heart rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are late decelerations on CTG?

A

gradual falls in HR that starts after the uterine contraction has already begun –> delay btw the uterine contraction and the deceleration.

The lowest point of the declaration occurs after the peak of the contraction.

Late decelerations are caused by hypoxia in the fetus, and are a more concerning finding.
They may be caused by: - excessive uterine contractions,
- maternal hypotension
- maternal hypoxia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are variable decelerations on CTG?

A

abrupt decelerations that may be unrelated to uterine contractions. Fall >15 BPM from the baseline.
The lowest point of the declaration occurs within 30 seconds, and the deceleration lasts < 2mins in total.
- often indicate intermittent compression of the umbilical cord, –> causing fetal hypoxia.

Brief accelerations before and after the deceleration are known as shoulders, and are a reassuring sign that the fetus is coping.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are prolonged decelerations on CTG?

A

Last between 2 and 10 minutes with a drop of more than 15 bpm from baseline.
This often indicates compression of the umbilical cord, causing fetal hypoxia.
These are abnormal and concerning.

36
Q

when is a CTG reassuring?

A
  • no decelerations
  • early decelerations
  • less than 90 mins of variable decelerations
    with no concerning features

Regular variable decelerations and late decelerations are classed as non-reassuring or abnormal, depending on the features. Prolonged decelerations are always abnormal.

37
Q

what are the 4 categories for CTG?

A
  1. Normal
  2. Suspicious: a single non-reassuring feature
  3. Pathological: two non-reassuring features or a single abnormal feature
  4. Need for urgent intervention: acute bradycardia or prolonged deceleration of more than 3 minutes
38
Q

what’s the rule of 3s for metal bradycardia?

A

3 minutes - call for help
6 minutes - move to theatre
9 minutes - prepare for delivery
12 minutes - deliver the baby (by 15 minutes)

39
Q

sinusoidal CTG

A

sine wave pattern
assoc with severe fatal anaemia
- bc vasa praevia with fatal haemorrhage

40
Q

DR C BRaVADO for CTG

A

DR C BRaVADO is a mnemonic often taught to assess the features of a CTG in a structured way. It involves assessing in order:
DR - Define Risk (define the risk based on the individual woman and pregnancy before assessing the CTG)
C - Contractions
BRa - Baseline Rate
V - Variability
A - Accelerations
D - Decelerations
O - Overall impression (given an overall impression of the CTG and clinical picture)

If you are asked to assess a CTG in your exams, use the DR C BRaVADO structure to describe each feature in turn. Give an overall impression of the CTG as being normal (all features are reassuring), suspicious, pathological, or need for urgent intervention, as described in the NICE guidelines (2017).

41
Q

what is cord prolapse?

A

when the umbilical cord descends below the presenting part of the fetus and through the cervix into the vagina, after rupture of the fetal membranes.

There is a significant danger of the presenting part compressing the cord, resulting in fetal hypoxia.

42
Q

risk factors for cord prolapse?

A
  • abnormal lie >37 weeks
    = unstable, transverse or oblique
    –> space for cord to prolapse

(in cephalic lie, no room for cord to descend)

43
Q

diagnosis of cord prolapse?

A

signs of fetal distress on CTG

vaginal exam or speculum

44
Q

management of cord prolapse

A

relieve pressure on cord
- knee-chest position (all 4s) or lie in left lateral position

totolytics (terbutaline) to minimise contractions

emergency C-section

do not push cord back in
keep cord warm and wet, minimal handling (causes vasospasm)

45
Q

what medication do you give after instrumental delivery?

A

1 dose co-amoxiclav

46
Q

indications for instrumental delivery

A

Failure to progress
Fetal distress
Maternal exhaustion
Control of the head in various fetal positions

also inc risk of needing instrumental delivery when epidural used

47
Q

risks of instrumental delivery to mother

A 
Postpartum haemorrhage
Episiotomy
Perineal tears
Injury to the anal sphincter
Incontinence of the bladder or bowel
Nerve injury (obturator or femoral nerve)
48
Q

risks of instrumental delivery to baby

A

The key risks to remember to the baby are:
Cephalohaematoma with ventouse
Facial nerve palsy with forceps (also fat necrosis, resolves)

Rarely there can be serious risks to the baby:
Subgaleal haemorrhage (most dangerous)
Intracranial haemorrhage
Skull fracture
Spinal cord injury
49
Q

what nerve injuries can mother get on instrumental delivery?

A

rare, resolves over 6-8 weeks

Femoral N

  • may be compressed against the inguinal canal during a forceps delivery.
  • Injury –> weakness of knee extension, loss of the patella reflex and numbness of the anterior thigh and medial lower leg.

Obturator nerve

  • may be compressed by forceps or by the fetal head during NVD
  • Injury –> weakness of hip adduction and rotation, and numbness of the medial thigh.
50
Q

3 nerve injuries in birth (usually unrelated to instrumental delivery)

A

lateral cutaneous nerve of the thigh

  • runs under the inguinal ligament.
  • Prolonged flexion at the hip while in the lithotomy position can result in injury
  • -> numbness of the anterolateral thigh.

The lumbosacral plexus

  • may be compressed by the fetal head during the 2nd stage of labour.
  • Injury –> foot drop and numbness of the anterolateral thigh, lower leg and foot.

The common peroneal nerve

  • may be compressed on the head of the fibula whilst in the lithotomy position.
  • Injury –> foot drop and numbness in the lateral lower leg.
51
Q

risk factors for perineal tear

A 
Perineal tears are more common with:
First births (nulliparity)
Large babies (over 4kg)
Shoulder dystocia
Asian ethnicity
Occipito-posterior position
Instrumental deliveries
52
Q

4 degrees of perineal tear

A

each involving injury to tissue beyond the previous:

First-degree - injury limited to the frenulum of the labia minora (where they meet posteriorly) and superficial skin
Second-degree - including the perineal muscles, but not affecting the anal sphincter
Third-degree - including the anal sphincter, but not affecting the rectal mucosa
Fourth-degree - including the rectal mucosa

Third-degree tears can be subcategorised as:
3A - less than 50% of the external anal sphincter affected
3B - more than 50% of the external anal sphincter affected
3C - external and internal anal sphincter affected

53
Q

what are the 2 options for management of the 3rd stage of labour?

A

physiological - placenta delivered by maternal effort (no meds or cord traction)

or
active - assisted

54
Q

how can you actively manage 3rd stage labour?

A
  • IM oxytocin (10 IU) –> contracts uterus

cord clamped and cut within 5 mins of birth (wait 1-3 mins before clamp unless baby needs resus)

palpate abdo for uterine contractions

  • controlled cord traction during contractions
  • 1 hand presses uterus upwards –> prevent uterine prolapse

Aim: deliver placenta in 1 piece

massage uterus until contracted and firm

examine placenta to ensure complete and no tissue remains

shortens 3rd stage, dec risk of bleeding
assoc with nausea and vomiting

55
Q

when is active management of 3rd stage labour initiated?

A

routinely offered to all women to reduce the risk of PPH
Also if:
Haemorrhage
>60-minute delay in delivery of the placenta (prolonged third stage)

56
Q

criteria for PPH

A

500ml after vaginal delivery

1000ml after C-section

57
Q

minor or major PPH

A

Minor PPH - under 1000ml blood loss
Major PPH - over 1000ml blood loss

Major PPH can be further sub-classified as:
Moderate PPH - 1000 - 2000ml blood loss
Severe PPH - over 2000ml blood loss

58
Q

primary or secondary PPH

A

Primary PPH: bleeding within 24 hours of birth

Secondary PPH: from 24 hours to 12 weeks after birth

59
Q

four T’s for PPH causes

A

T - Tone (uterine atony - the most common cause)
T - Trauma (e.g. perineal tear)
T - Tissue (retained placenta)
T - Thrombin (bleeding disorder)

60
Q

mechanical management of PPH

A

Rubbing the uterus through the abdomen to stimulates a uterine contraction (referred to as “rubbing up the fundus”)
Catheterisation (bladder distention prevents uterus contractions)

61
Q

medical management of PPH

A

Oxytocin (slow injection followed by continuous infusion) (infuse 40 units in 500mls)
Ergometrine IV or IM stimulates smooth muscle contraction (contraindicated in hypertension)
Carboprost (IM) is a prostaglandin analogue and stimulates uterine contraction (caution in asthma)
Misoprostol (sublingual) is also a prostaglandin analogue and stimulates uterine contraction
Tranexamic acid (IV) is an antifibrinolytic that reduces bleeding

62
Q

surgical management of PPH

A

Intrauterine balloon tamponade - inserting an inflatable balloon into the uterus to press against the bleeding
B-Lynch suture - putting a suture around the uterus to compress it
Uterine artery ligation - ligation of one or more of the arteries supplying the uterus to reduce the blood flow
Hysterectomy is the “last resort” but will stop the bleeding and may save the woman’s life

63
Q

most common cause of secondary PPH

A

RPOC or infection (endometritis)

64
Q

investigation and management of secondary PPH

A

Investigations involve:
Ultrasound for retained products of conception
Endocervical and high vaginal swabs for infection

Management depends on the cause:
Surgical evacuation of retained products of conception
Antibiotics for infection

65
Q

4 categories of emergency C-section

A

Category 1: There is an immediate threat to the life of the mother or baby. Decision to delivery time is 30 minutes.
Category 2: There is not an imminent threat to life, but caesarean is required urgently due to compromise of the mother or baby. Decision to delivery time is 75 minutes.
Category 3: Delivery is required, but mother and baby are stable.
Category 4: This is an elective caesarean,

66
Q

2 possible incisions for C-section

A

Pfannenstiel incision is a curved incision two fingers width above the pubic symphysis
Joel-cohen incision is a straight incision that is slightly higher (this is the recommended incision)

67
Q

risks of spinal or general anaesthetic

A 
Allergic reactions or anaphylaxis
Hypotension
Headache
Urinary retention
Nerve damage (spinal anaesthetic)
Haematoma (spinal anaesthetic)
Sore throat (general anaesthetic)
Damage to the teeth or mouth (general anaesthetic)
68
Q

4 measures to reduce the risks during caesarean section

A
  1. H2 receptor antagonists (e.g. ranitidine) or PPI(e.g. omeprazole) before the procedure
    - -> risk of aspiration penumonitis caused by acid reflux from prolonged period lying flat
  2. Prophylactic antibiotics during the procedure to reduce the risk of infection
  3. Oxytocin during the procedure to reduce the risk of PPH
  4. VTE prophylaxis with LMWH
69
Q

2 key causes of sepsis in pregnancy

A

chorioamnionitis - MC

UTI

70
Q

3 signs of chorioamnionitis

A

Abdominal pain
Uterine tenderness
Vaginal discharge

with sepsis signs

71
Q

what is an amniotic fluid embolism?

A

amniotic fluid into mom’s blood (in labour and delivery)
contains fetal tissue –> immune reaction bc foreign –> systemic illness, more similar to anaphylaxis than VTE
20% mortality rate

presents like sepsis, PE, anaphylaxis
manage ABCDE, supportive

72
Q

The main risk factors for amniotic fluid embolus

A

Increasing maternal age
Induction of labour
Caesarean section
Multiple pregnancy

73
Q

difference between in/complete uterine rupture

A

comp of labour, myometrium ruptures

incomplete or uterine dehiscene
- uterine serosa (perimetrium) surrounding the uterus remains intact.

complete
- serosa ruptures with myometrium
–> contents into peritoneal cavity
baby into cavity, lots of bleeding

74
Q

risk factors for uterine rupture

A

main: previous C-section –> scar is point of weakness, may rupture with xc pressure (oxytocin stem)

Vaginal birth after caesarean (VBAC)
Previous uterine surgery
Increased BMI
High parity
Increased age
Induction of labour
Use of oxytocin to stimulate contractions

(rare if 1st birth)

75
Q

presentation of uterine rupture

A

acutely unwell mom + abnormal CTG

Ceasing of uterine contractions!!
Abdominal pain
Vaginal bleeding
Hypotension
Tachycardia
Collapse
76
Q

management of uterine rupture

A

Resuscitation and transfusion may be required.
Emergency caesarean section is necessary to remove the baby, stop any bleeding and repair or remove the uterus (hysterectomy).

77
Q

the 3 P’s that influence progress in labour

A

Power (uterine contractions)
Passenger (size, presentation and position of the baby)
Passage (the shape and size of the pelvis and soft tissues)

Psyche can be added as a fourth P, referring to the support and antenatal preparation for labour and delivery.

78
Q

consider delayed 1st stage of labour when

A

Less than 2cm of cervical dilatation in 4 hours

Slowing of progress in a multiparous women

79
Q

when is a partogram used?

A

Women are monitored for their progress in the first stage of labour using a partogram.

80
Q

what is recorded on a partogram?

A

Cervical dilatation (measured by a 4-hourly vaginal examination)
Descent of the fetal head (in relation to the ischial spines)
Maternal pulse, blood pressure, temperature and urine output
Fetal heart rate
Frequency of contractions
Status of the membranes, presence of liquor and whether the liquor is stained by blood or meconium
Drugs and fluids that have been given

81
Q

how can you tell if labour progressing on a partogram?

A

2 lines labelled alert and action
plot cervix dilation against duration of labour
if cross to right, too slow

Cross alert line –> indication for amniotomy (artificially ROM) and a repeat examination in 2 hours.
Cross action line –> escalate care

82
Q

what is a delayed 2nd stage labour?

A

when the active second stage (pushing) lasts over:
2 hours in a nulliparous woman
1 hour in a multiparous woman

83
Q

what does attitude of foetus mean?

A

refers to the posture of the fetus.

For example, how the back is rounded and how the head and limbs are flexed.

84
Q

3 types of breech presentation

A

Breech presentation - the legs are first. This can be:
Complete breech - with hips and knees flexed (like doing a cannonball jump into a pool)
Frank breech - with hips flexed and knees extended, bottom first
Footling breech - with a foot hanging through the cervix

85
Q

how can you stimulate contractions during labour?

A

oxytocin - 1st line
It is started at a low rate and titrated up at intervals of at least 30 minutes as required. The aim is for 4 - 5 contractions per 10 minutes.
monitor fetus

Obs and Gynae (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions