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Isleans Mrcog Part 2 > Labour & Delivery > Flashcards

Labour & Delivery Flashcards

1
Q

Classification in operative delivery

Outlet is

A

Fetal scalp visible without parting labia

Skull on pelvic floor

OA or OP or less than 45 degree to right or left

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2
Q

Classification in operative delivery

Low is

A

Station +2 or more, not on pelvic floor

OA OP or OT

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3
Q

Classification in operative delivery

Mid is

A

No more than 1/5 palpable per abdomen

Station 0 to +1

OA OP or OT

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4
Q

By how long should labour ideally be postponed to post MI

A

2-3 weeks

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5
Q

In cases of MOH what should the fibrinogen level be maintained above

A

1g

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6
Q

By how much is the risk of intracranial haemorrhage increased by with sequential instrumental delivery

A

2-3x

1:256

Compared to

1: 860 for vacuum
1: 664 for forceps
1: 954 for emcs

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7
Q

What % of neonatal infection developing within 48hr of birth in the U.K. Is due to GBS

A

50%

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8
Q

What % of symptomatic uterine ruptures are associated with perinatal mortality

A

5%

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9
Q

What is the incidence of cord prolapse in breech presentation

A

1%

0.1-0.6% of all births

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10
Q

What is the increased risk of perinatal mortality when cord prolapse occurs in the community

A

10x

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11
Q

In otherwise uncomplicated preterm labour, by how much does tocolysis delay delivery by

A

7 days

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12
Q

Regarding sickle cell disease during labour

What should be done if stars fall <94%

A

ABG and give O2

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13
Q

What proportion of intrapartum CTG with reduced variability and late decelerations result in moderate to severe cerebral palsy

A

0.2%

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14
Q

Which outcomes has STAN monitoring been shown to reduce

A

Operative vaginal delivery

FBS

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15
Q

By how much does prophylactic oxytocin reduce the risk of PPH

A

60%

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16
Q

Regarding untreated chlamydia infection at the time of delivery

What % of women will develop puerperal infection

A

34%

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17
Q

Regarding untreated chlamydia infection at the time of delivery

What % of neonates will develop ophthalmia neonatorum

A

50%

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18
Q

Regarding chlamydia infection at the time of delivery

What % of neonates will develop chlamydia pneumonitis

A

15%

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19
Q

Regarding chlamydia infection in pregnancy

When after treatment should a test of cure be completed

A

5-6 weeks

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20
Q

Regarding epidural

What is the risk of death

A

1: 140,000

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21
Q

Regarding epidural

What is the risk of permanent nerve damage

A

1:13,000

22
Q

Regarding epidural

What is the risk of significant hypotension

A

2%

1:50

23
Q

What is the effect of oxytocin on duration of labour

A

Shorten 1st stage by 1.3 hours

No effect on mode of delivery

24
Q

What are the benefits of upright position in labour

A

Shortens 1st stage labour by 1.3 hours
Reduces need for epidural
Reduced 2nd stage
Reduces operative vaginal delivery

25
Q

What are the benefits of hypnobirthing

A

Reduced pain
Less epidural
Shorter 2st stage

26
Q

What is the half life of entonox

A

2-3 min

27
Q

How long does pethidine stay in the neonate for

A

6 days

28
Q

What is the risk of temporary nerve damage following epidural

A

1:1000

29
Q

What is the failure rate for epidural

A

1/10

30
Q

How long does an epidural take to set up and how long it till it is effective

A

20 min to set up

20min till it’s effective

31
Q

Within what time frame should an epidural be sited after patient request

A

Within 30 minutes or a second anaesthetist should be called

32
Q

Regarding first labours

What is the average length

How many hours are they unlikely to go beyond

A

Average 8 hours, unlikely to go beyond 18 hours

33
Q

Regarding multip labours

What is the average length

How many hours are they unlikely to go beyond

A

Average 5 hours, unlikely to go beyond 12 hours

34
Q

By how long does ARM shorten the duration of labour?

A

1hr

35
Q

How soon after suspected delay in the 1st stage of labour should a VE be performed

What progress is acceptable

A

After 2 hours

Diagnose delay if progress is less than 1cm

36
Q

By how much does active management of the third stage reduce the risk of pph >1L

A

50%

37
Q

By how much does physiological vs active management of the third stage increase the risk of needing a blood transfusion

A

3x

38
Q

What diameter is seen in a

Face presentation

How many cm

A

Submento-bregmatic

9.5cm

39
Q

What diameter is seen in a

Brow presentation

How many cm

A

Mento-vertical

13cm

40
Q

What diameter is seen in a

OP presentation

How many cm

A 
Suboccipito-frontal partially flexed 
10.5cm
Or
Occipital-frontal d
Deflected 
11.5cm
41
Q

What diameter is seen in a

Well flexed OA

How many cm

A

Subocipito-bregmatic

9.5cm

42
Q

What diameter is seen in a

Partially flexed OA

How many cm

A

Subbocipital-frontal

10.5cm

43
Q

What is the risk of neonatal infection if mother has 1st HVS infection within 6 weeks of delivery

A

41%

44
Q

By how much do intarapartum Abx reduce the risk of neonatal GBS sepsis

A

80%

45
Q

Overall incidence of 3/4 degree tear

A

2.9%

46
Q

incidence of 3/4 degree tear in Primips

A

6.1%

47
Q

incidence of 3/4 degree tear in multips

A

1.7%

48
Q

Incidence of shoulder dystocia

A

0.5%

49
Q

Regard shoulder dystocia

What is the risk of brachial plexus injury

Of which hoe many are permenant

A

2-16%

10% permanent

50
Q

Regard shoulder dystocia

By how much is the risk increased in DM

A

2-4x

51
Q

Regard shoulder dystocia

What is the risk of recurrence

A

1-25%

10x that of background population

Isleans Mrcog Part 2 (26 decks)

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