Labour and Delivery Complications Flashcards
What is a hypoactive uterus?
A hypoactive uterus refers to inadequate uterine contractions, which can lead to delayed labor progression or postpartum hemorrhage (PPH).
What are the main causes of a hypoactive uterus?
Uterine overdistension (e.g., multiple pregnancy, polyhydramnios).
Prolonged labor.
Maternal exhaustion.
Chorioamnionitis.
Oxytocin receptor desensitization.
One common cause of a hypoactive uterus is __________, which refers to an infection of the fetal membranes.
Chorioamnionitis.
What are the clinical signs of a hypoactive uterus?
Poor uterine contractions during labor.
Slow cervical dilation or labor progression.
Postpartum hemorrhage.
How is hypoactive uterus diagnosed?
Clinical assessment of contraction strength.
Partogram showing slow labor progression.
Palpation of the uterus after delivery to assess uterine tone.
What are the management options for hypoactive uterus during labor?
Augmentation with oxytocin to stimulate stronger contractions.
Consider amniotomy.
Monitor maternal and fetal well-being.
What are the management options for a hypoactive uterus postpartum?
Uterine massage.
Oxytocin administration to improve uterine tone.
Consider carboprost or ergometrine for refractory cases.
Surgical options if medical management fails (e.g., Bakri balloon, surgery).
The first-line treatment for a hypoactive uterus is administration of __________ to stimulate uterine contractions.
Oxytocin.
What are the potential complications of a hypoactive uterus?
Prolonged labor.
Failure to progress.
Postpartum hemorrhage (PPH).
Maternal infection.
A woman in active labor shows slow cervical dilation and weak uterine contractions. What management steps should be considered?
Administer oxytocin to augment labor.
Consider amniotomy if membranes are intact.
Monitor for signs of maternal or fetal distress.
What is premature labor?
Premature labor is defined as labor occurring before 37 weeks of gestation.
What are the main risk factors for premature labor?
Multiple pregnancy
Previous preterm birth
Cervical insufficiency
Infections (e.g., chorioamnionitis, bacterial vaginosis)
Polyhydramnios
Smoking, alcohol, or drug use
Maternal age <18 or >35
Short inter-pregnancy interval
Placental abruption
A major risk factor for premature labor is ____________, which refers to an incompetent cervix that dilates too early in pregnancy.
Cervical insufficiency
What are the clinical signs and symptoms of premature labor?
Regular uterine contractions before 37 weeks
Cervical dilation and effacement
Pelvic pressure
Lower back pain
Vaginal discharge (mucus plug or bloody show)
What investigations are used to assess premature labor?
Fetal fibronectin test (fFN): Indicates likelihood of preterm labor.
Transvaginal ultrasound (TVUS): Assesses cervical length.
CTG (Cardiotocography): Monitors fetal well-being.
Speculum examination: Evaluates cervical changes.
Infection screening: Checks for chorioamnionitis or BV.
What criteria are used to diagnose premature labor?
Contractions: Regular uterine contractions (>4 in 20 mins).
Cervical changes: Dilation and effacement before 37 weeks.
True/False
Q: A positive fetal fibronectin (fFN) test indicates a high risk of imminent delivery.
True.
What medications are used to suppress contractions in premature labor?
Nifedipine (calcium channel blocker)
Atosiban (oxytocin receptor antagonist)
Indomethacin (NSAID)
What steroid is used to promote fetal lung maturity in premature labor?
Betamethasone or dexamethasone.
Administration of __________ before 34 weeks of gestation reduces the risk of neonatal respiratory distress syndrome (RDS).
Corticosteroids
What is the purpose of administering magnesium sulfate in premature labor?
Neuroprotection for the fetus, reducing the risk of cerebral palsy.
What antibiotics are used in the management of premature labor with prolonged rupture of membranes?
IV erythromycin or penicillin (to reduce infection risk).
A 30-week pregnant woman presents with regular contractions and cervical dilation of 2 cm. What should be the next steps in management?
Administer corticosteroids for lung maturity.
Start tocolytics to suppress labor if no contraindications.
Magnesium sulfate for neuroprotection.
Monitor for infection and fetal distress.
When is tocolysis contraindicated in premature labor?
Chorioamnionitis
Severe pre-eclampsia
Placental abruption
Fetal distress
Severe intrauterine growth restriction (IUGR)