Labour & Delivery Flashcards
Classification in operative delivery
Outlet is
Fetal scalp visible without parting labia
Skull on pelvic floor
OA or OP or less than 45 degree to right or left
Classification in operative delivery
Low is
Station +2 or more, not on pelvic floor
OA OP or OT
Classification in operative delivery
Mid is
No more than 1/5 palpable per abdomen
Station 0 to +1
OA OP or OT
By how long should labour ideally be postponed to post MI
2-3 weeks
In cases of MOH what should the fibrinogen level be maintained above
1g
By how much is the risk of intracranial haemorrhage increased by with sequential instrumental delivery
2-3x
1:256
Compared to
1: 860 for vacuum
1: 664 for forceps
1: 954 for emcs
What % of neonatal infection developing within 48hr of birth in the U.K. Is due to GBS
50%
What % of symptomatic uterine ruptures are associated with perinatal mortality
5%
What is the incidence of cord prolapse in breech presentation
1%
0.1-0.6% of all births
What is the increased risk of perinatal mortality when cord prolapse occurs in the community
10x
In otherwise uncomplicated preterm labour, by how much does tocolysis delay delivery by
7 days
Regarding sickle cell disease during labour
What should be done if stars fall <94%
ABG and give O2
What proportion of intrapartum CTG with reduced variability and late decelerations result in moderate to severe cerebral palsy
0.2%
Which outcomes has STAN monitoring been shown to reduce
Operative vaginal delivery
FBS
By how much does prophylactic oxytocin reduce the risk of PPH
60%
Regarding untreated chlamydia infection at the time of delivery
What % of women will develop puerperal infection
34%
Regarding untreated chlamydia infection at the time of delivery
What % of neonates will develop ophthalmia neonatorum
50%
Regarding chlamydia infection at the time of delivery
What % of neonates will develop chlamydia pneumonitis
15%
Regarding chlamydia infection in pregnancy
When after treatment should a test of cure be completed
5-6 weeks
Regarding epidural
What is the risk of death
1: 140,000
Regarding epidural
What is the risk of permanent nerve damage
1:13,000
Regarding epidural
What is the risk of significant hypotension
2%
1:50
What is the effect of oxytocin on duration of labour
Shorten 1st stage by 1.3 hours
No effect on mode of delivery
What are the benefits of upright position in labour
Shortens 1st stage labour by 1.3 hours
Reduces need for epidural
Reduced 2nd stage
Reduces operative vaginal delivery
What are the benefits of hypnobirthing
Reduced pain
Less epidural
Shorter 2st stage
What is the half life of entonox
2-3 min
How long does pethidine stay in the neonate for
6 days
What is the risk of temporary nerve damage following epidural
1:1000
What is the failure rate for epidural
1/10
How long does an epidural take to set up and how long it till it is effective
20 min to set up
20min till it’s effective
Within what time frame should an epidural be sited after patient request
Within 30 minutes or a second anaesthetist should be called
Regarding first labours
What is the average length
How many hours are they unlikely to go beyond
Average 8 hours, unlikely to go beyond 18 hours
Regarding multip labours
What is the average length
How many hours are they unlikely to go beyond
Average 5 hours, unlikely to go beyond 12 hours
By how long does ARM shorten the duration of labour?
1hr
How soon after suspected delay in the 1st stage of labour should a VE be performed
What progress is acceptable
After 2 hours
Diagnose delay if progress is less than 1cm
By how much does active management of the third stage reduce the risk of pph >1L
50%
By how much does physiological vs active management of the third stage increase the risk of needing a blood transfusion
3x
What diameter is seen in a
Face presentation
How many cm
Submento-bregmatic
9.5cm
What diameter is seen in a
Brow presentation
How many cm
Mento-vertical
13cm
What diameter is seen in a
OP presentation
How many cm
Suboccipito-frontal partially flexed 10.5cm Or Occipital-frontal d Deflected 11.5cm
What diameter is seen in a
Well flexed OA
How many cm
Subocipito-bregmatic
9.5cm
What diameter is seen in a
Partially flexed OA
How many cm
Subbocipital-frontal
10.5cm
What is the risk of neonatal infection if mother has 1st HVS infection within 6 weeks of delivery
41%
By how much do intarapartum Abx reduce the risk of neonatal GBS sepsis
80%
Overall incidence of 3/4 degree tear
2.9%
incidence of 3/4 degree tear in Primips
6.1%
incidence of 3/4 degree tear in multips
1.7%
Incidence of shoulder dystocia
0.5%
Regard shoulder dystocia
What is the risk of brachial plexus injury
Of which hoe many are permenant
2-16%
10% permanent
Regard shoulder dystocia
By how much is the risk increased in DM
2-4x
Regard shoulder dystocia
What is the risk of recurrence
1-25%
10x that of background population
