Maternity Flashcards
Post partum haemorrhage amount of blood loss
Primary less than 500 ml in 24 hours
Minor between 500ml-1000ml in 24 hours
Major over 1000 ml in 24 hours
What can apply when looking at blood loss
Rule of 30
Systolic bp drop by 30
Pulse increase by 30 or more
Haemoglonin decreased by 30
Haemotocrit decreased by 30
What does misoprostol do
Effective at reducing bleeding
More prone to side effects then oxytocin
Synthetic prostaglandin = smooth muscle contraction
What does syntometrine do
Combination of oxytocin and ergometrine
Enhance uterine contraction
Preganant women have more oxytocin receptors
If ongoing bleeding after given maternity drugs give
TXA 1g in 10 minutes repeat once if necessary
When is a miscarriage
Anytime before 24 weeks
If bleeding is after 20 weeks
The uterus is above umbilicus consider placenta abruption/ praevia
Placenta previa is
When the placenta partially or completely covers the cervix
Signs and symptoms of pre eclampsia
Hypertension Abdo pain Oedema Headaches, blurred vision Protein in urine
If seizure when pregnant give diazepam
In 2-3 minutes rather than 5
What to do in breach birth
Allow to move spontaneously
Guide head
Do not touch baby or umbilical cord
What to do if won’t come out
Mcroberts
Suprapubic pressure
All fours
Hormones involved in birth
Oxytocin
Melatonin
Adrenaline - reduces effect on oxytocin
Why is semi-recumbent position not ideal for giving birth
Aorta and vena cava compression by uterus
Pushing uphill
What to do if baby born in amniotic sac
Find where it is rupture and pull over the babies head
What to do if baby is born in amniotic sac with maternal wall of placenta attached
use fingers push straight through
If need scissors pinch and cut so don’t catch baby
Newborn resus
Can perform still attached to mother Less than 22 weeks we do not resus More than 22 weeks thermal care, inflation breaths No chest compressions below 24 weeks No ecg dots below 32 weeks
What to do in water birth
Instruct to get out and tell partner PPE - use gloves, sleeve, aprons Temp water - 37 C Don’t let Bob in and out of water Let mother bring baby up out of water Get woman out of pool to deliver placenta
What to do after birth
Skin to skin contact
If baby is warm leave hat off as the smell is most in the head
Try to get baby to latch on
Wait for cord to stop pulsating - flat white and opaque. Allows the placenta to drain the blood, stem cells and antibodies
What to do after birth placenta
1 hour = retained
After 20 minutes at risk of pph should cannulate and be going to hospital
