Module 10 - Management of Labour Flashcards
Which variable decels are reassuring?
Variable decels with no concerning features for <90 minutes
Which type of decels are non-reassuring?
1) Variable decels with NO concerning features >90 minutes
2) Variable decels with concerning features in up to 50% contractions for >30 mins
3) Variable decels with concerning features in >50% contractions for <30 mins
4) Late decels in up to 50% contractions for <30 mins with no fetal/maternal risk factors, i.e. vaginal bleeding or significant meconium
Which type of decels are abnormal?
1) Variable decels with concerning features for >50% contractions for >30 mins (or less if any fetal/maternal risk factors)
2) Late decels for >30 minutes (or less if any fetal/maternal risk factors)
3) Acute bradycardia/single prolonged deceleration lasting >3 mins
Concerning characteristics of variable decelerations?
1) Lasting >60 seconds
2) Reduced baseline variability within the deceleration
3) Failure to return to baseline
4) Biphasic (W) shape
5) No shouldering
If a woman had a previous placental abruption what is her risk of it in this pregnancy?
4%
If a woman had 2x previous placental abruptions what is her risk of it in this pregnancy?
25%
The rate of shoulder dystocia in women who have had a previous pregnancy complicated by shoulder dystocia is?
10x that of the general population
What is the success rate of VBAC?
72-75%
What is the success rate of VBAC when the woman has previously delivered vaginally?
85-90%
Previous successful vaginal delivery is the best predictor of VBAC success. Those with a previous vaginal delivery have success rates of 85-90%
You are asked by the midwife to talk to pregnant woman in the antenatal clinic. A friends baby was diagnosed with early onset neonatal group B Streptococcal disease (EOGBS). She is worried this may happen to her baby.
What is the incidence of EOGBS in the UK?
0.5 in 1,000
What is the incidence of early onset GBS disease if GBS +ve in previous pregnancy?
0.9 in 1,000
What is the incidence of early onset GBS disease if there is a hx of GBS colonisation in this pregnancy?
Risk of EOGBS if GBS in current pregnancy 2.3/1000 births
What is the incidence of early onset GBS disease in a term pregnancy with no risk factors?
0.2 in 1,000
What is the incidence of early onset GBS disease if there is intrapartum pyrexia >38C?
5.3 in 1,000
What is the rate of SVD following IOL with prostaglandins alone?
60-70%
A woman delivers her baby at 27 weeks and 3 days gestation. The baby stayed in the neonatal intensive care unit for 3 weeks and died of sepsis.
What is the proportion of the UK neonatal deaths that are represented by premature babies?
65%
A woman attends the delivery suite in active labour at 23 weeks and 12 days. What is the chance of survival if the woman delivers?
11%
Magnesium sulphate given to mothers shortly before delivery reduces the risk of cerebral palsy and protects gross motor function in those infants born pre-term.
What is the cut off gestational age up to which magneisum sulphate should be offered?
29 weeks and 6 day
A woman with BMI 36 has had a caesarean section in her first pregnancy due to delayed progress in the first stage of labour. She attends the antenatal clinic in her second pregnancy.
She asks about the chance of successful VBAC in her case?
40%
A 30 year old lady attends the delivery suite in labour. She was found to be a GBS carrier in her first pregnancy. Her current pregnancy is uneventful and her GBS status is unknown. She is found to be 8cm dilated. 2 hours later she delivers a 3.2kg baby. The baby ecomes unwell 2 days after delivery.
What is the chance that the baby has an early onset GBS infection?
50%
