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Gaby’s PassMRCOG repeats > Management of Delivery > Flashcards

Management of Delivery Flashcards

1
Q

What is the risk of uterine rupture in a future pregnancy following CS?

A

2-7:1000

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2
Q

With expectant management of intrauterine fetal death, what is the risk of DIC within 4 weeks?

A

10%

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3
Q

What % of births in the UK are by elective CS?

A

15%
GTG says 10% (2015)

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4
Q

Following placenta praevia, what is the risk of repeat placenta praevia in future pregnancies?

A

23:1000

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5
Q

What is the risk of infection at CS?

A

6%

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6
Q

What is the risk of VTE following CS,
a) generally & b) with placenta praevia?

A

a) 4-16:10,000
b) 3%

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7
Q

What is the presenting diameter in a face presentation?

A

9.5cm
Submentobregmatic

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8
Q

What is the risk of placenta praevia following different numbers of Caesareans?

A

0: 0.25%
1: 0.6%
2: 1.6%
3: 3.3%
4: 10%

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9
Q

What % of stillborn babies have a chromosomal abnormality?

A

6%

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10
Q

What % of women will have some degree of faecal incontinence 12 months after OASI?

A

30%

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11
Q

How does IOL for VBAC affect the risk of needing a CS?

A

1.5x greater than spontaneous

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12
Q

What is the incidence of umbilical cord prolapse a) overall, b) in breech presentation?

A

a) 0.1-0.6%
b) 1%

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13
Q

What is the risk of maternal death
a) with VBAC
b) with elective repeat CS?

A

a) 4:100,000
b) 13:100,000

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14
Q

What are the success rates for VBAC in different scenarios?

A

Overall: 72-75%
Prev successful vaginal birth: 85-90%
Prev CS for malpresentation: 84%
Prev CS for fetal distress: 73%
Prev CS for labour dystocia: 64%

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15
Q

What measures can reduce the risk of operative vaginal birth?

A
  1. Continuous support
  2. Upright & lateral positions
  3. Avoiding epidural
  4. Delayed pushing if epidural
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16
Q

What is the rate of SCBU admission following a) CS at full dilatation, b) operative vaginal birth?

A

a) 11%
b) 6%

17
Q

In what situations are there higher failure rates of operative vaginal birth?

A
  1. Maternal BMI > 30
  2. EFW > 4kg
  3. OP position
  4. Mid-cavity
18
Q

What structures are divided during a mediolateral episiotomy?

A
  1. Vaginal epithelium
  2. Transverse perineal muscle
  3. Bulbocavernosus muscle
  4. Perineal skin
19
Q

Which factors confer a higher risk of planned vaginal breech birth, so CS recommended?

A
  1. Hyperextended neck on US
  2. EFW > 3.8kg
  3. EFW < 10th centile
  4. Footling presentation
  5. Evidence of antenatal fetal compromise
20
Q

What is the risk of ureteric injury at CS?

A

3:10,000

21
Q

How should MCMA twins be delivered?

A

CS 32-34/40

Gaby’s PassMRCOG repeats (17 decks)

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