Labour Ward

Question 1

What is the acronym used to interpret CTGs?

Answer 1

Dr C Bravado

Question 2

What does Dr C Bravado stand for?

Answer 2

Define risk
Contractions
Baseline rate
Variability
Accelerations
Decelerations
Overall impression

Question 3

What is a normal foetal heatrate?

Answer 3

110-160bpm

Question 4

How long is one big square on a CTG?

Answer 4

1 minute

Question 5

Common causes of foetal bradycardia 100-120bpm?

Answer 5

Post-date

Occiput posterior/transverse presentation

Question 6

Causes of severe foetal bradycardia (<80bpm for 3 minutes)

Answer 6

Prolonged cord compression
Cord prolapse
Epidural/spinal anaesthetic
Maternal seizures
Rapid foetal descent

Question 7

Causes of foetal tachycardia

Answer 7

Hypoxia
Chorioamnionitis
Hyperthyroidism
Foetal/maternal anaemia
Foetal tachyarrhythmia

Question 8

What is reassuring variability on a CTG?

Answer 8

5-25bpm3

Question 9

What does reassuring CTG variability show?

Answer 9

Intact foetal neurological system

Question 10

What is non-reassuring variability on a CTG?

Answer 10

<5bpm for 30-50 mins

>25bpm for 15-25 mins

Question 11

What is abnormal variability on a CTG?

Answer 11

<5bpm for >50 mins
>25bpm for >25 mins
Sinusoidal pattern

Question 12

Causes of reduced variability?

Answer 12

Foetal sleeping <40bpm
Foetal acidosis (usually with decelerations)
Opiates, benzodiazepines, methyldopa, magnesium sulphate
Prematurity (<28 weeks)
Congenital heart abnormalities

Question 13

What are normal accelerations?

Answer 13

> 15bpm for more than 15 seconds

Question 14

What are decelerations?

Answer 14

> 15bpm for more than 15 seconds

Question 15

What are early decelerations?

Answer 15

Start when contraction begins and recover when contraction stops

Question 16

What causes early decelerations?

Answer 16

An increased in intracranial pressure during contractions causes an increase in vagal tone

Question 17

What type of decelerations are physiological and not pathological?

Answer 17

Early decelerations

Question 18

What are variable decelerations?

Answer 18

Rapid fall in baseline heart rate with a variable recovery phase
No relationship with contractions

Question 19

Causes of variable decelerations?

Answer 19

Decreased amniotic fluid
Umbilical cord compression
More worrying with “shoulders”

Question 20

What are late decelerations?

Answer 20

Begin at the peak of contractions and recover after the contractions ends

Question 21

Causes of late decelerations?

Answer 21

Reduced uteroplacental blood flow:

• Maternal hypotension
• Pre-eclampsia
• Uterine hyperstimulation

Question 22

How long are prolonged deceleration?

Answer 22

> 2 mins

Question 23

Causes of sinusoidal pattern on CTG?

Answer 23

Severe foetal hypoxia
Severe foetal anaemia
Foetal/maternal haemorrhage

Question 24

What are the 3 reasons a labour may not be progressing well?

Answer 24

1. Power
2. Passenger
3. Passage

Question 25

Why may reduced variability for less than 45 mins on a CTG be normal?

Answer 25

Foetal sleep cycles

Question 26

How long is labour in a prim?

Answer 26

8-12 hours

Question 27

How long is labour in a multiparous woman?

Answer 27

Around 5 hours

Question 28

What is the first latent phase of labour?

Answer 28

0-4cm dilatation

Question 29

What is the active first phase of labour?

Answer 29

4-10cm dilatation

Question 30

What is the normal length of the second stage of labour in a primip?

Answer 30

45-120 mins

Question 31

What is the normal length of the second stage of labour in a multiip?

Answer 31

15-25 mins