Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

midwifery > monitoring complex labour > Flashcards

monitoring complex labour Flashcards

1
Q

When to begin cardiotocograph antenatally ?

A

Mother: MP >120bpm x2 30mins apart
Temp 38> 0r 37.5 x2 1hour apart
Hypertension
2+ pro in urinalysis with hypertension

pain differ from cont
significant mec
PROM>24
Risk Factors

Baby: abnormal presentation
Transverse or oblique lie

high head
?fetal growth restriction
ahydramnios
polyhydramnios
Abnormal FH/Decel
Reduced FM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When to begin CTG in labour?

A 
Mother: MP >120bpm x2 30mins apart 
Temp 38> 0r 37.5 x2 1hour apart
Hypertension
2+ pro in urinalysis with hypertension
?chrorioamnionitis or sepsis
pain differ from cont
significant mec
PROM>24
Risk Factors
Vaginal bleeding
confirmed delay
Hypertonus or tachysystole
oxytocin
Baby: 
?fetal growth restriction
ahydramnios
polyhydramnios
Abnormal FH/Decel
Reduced FM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When to document normal CTG?

A

Hourly - more frequent if any concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When to monitor/document contractions?

A

1/2 hourly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the baseline influenced by?

A

both sympathetic and parasympathetic NS
Raised nerve impulse and catecholamine
reduce acetylcholiine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the variability controlled by?

A

sympathetic and parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can influence variability?

A

sleep cycling
maternal opiates
Fetal hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe accelerations

A

Controlled by somatic NS
Occur as a result of fetal activity
increase 15 beat 15sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are decels?

A

Drop in FHR 15 beat for 15sec
Implys hypoxia
Protective function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe earlys

A

uniformed
repetitive
start with contraction return to baseline with contraction
look the same but upsidedown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe variables

A

vary in shape timing and form
unconcerning:
shoulders
last <60sec

concerning :
last >60sec
no shouldering 
reduced variability within decel
fail/slow to return to baseline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a reassuring trace?

A 
110-160BPM
Variability 5-25bpm
Accelerations present 
Decels: none or early
variable no concerning features <90mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Whats a non-reassuring trace?

A

100-109bpm Or 161-180
variablity <5bpm/50mins
>25 25mins
Decels: variable no concerning features >90mins
variables with concerning characteristics upto50% for 30mins
Variables with concerning characteristics >50% of cont <30
Late decels 50% cont <30 mins no risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Abnormal

A 
<100 >180
Variable <5bpm/>50mins >25bpm/>25mins
sinusodial
Variable with concerning features >50%/>30mins
Lates decels 30mins
acute bracy or prolonged decel >3mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is
normal
suspicious
pathological trace?

A

Normal - all features are reassuring
abnormal - 1 non-reassuring and 2 reassuring
Pathological- 2 non-reassuring or 1 abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of a suspicious CTG?

A 
correct underlying cause  hypotension hyperstimulation
Full Obs
conservative measures
inform obstetrician
document all and plan for obs <1hour
17
Q

What is the management of a pathological CTG?

A 
Full obs 
Inform obstetrician/coordinator r/v
Exclude acute events
correct underlying cause hypotension hyperstimulation 
conservative measures

If still path- further r/v
fetal scalp stimulation
Consider FBS or expediting birth

18
Q

Manage an brady or prolonged decel

A 
Urgent help
rule out acute event 
correct underlying causes 
start conservative measures
prep for urgent birth
consider expediting birth
19
Q

Describe gradually evolving hypoxia..

9 steps

A

normal ctg - decels- loss of acels- catecholamines-raising baseline reduce variability- baseline instability - terminal brady - fetal demise

20
Q

whats a subacute hypoxia

A

HR in a decel more than at baseline

21
Q

indications for FBS

A

no response to digital stimulus

22
Q

contraindications for FBS

A

prolonged brady
prolonged 2nd stage
maternal pyrexia or sepsis
prem

23
Q

PH: For FBS
Normal
Boarderline
Abnormal

A

Normal :7.25>
Borderline: 7.21-7.24
Abnormal <7.20

24
Q

Lacates: For FBS
Normal
Borderline
Abnormal

A

Normal 4.1mmol/l<
Bordline 4.2-4.8mmol/l
Abnormal 4.9mmol >

25
Q

PH: cord bloods

A

Arterial:7.26

Venous 7.35

26
Q

Base deficit: cord bloods

A

Arterial 2.3mmo/l

Venous 2.9mmol/l

27
Q

What is acidaemia?

A

Low blood PH

28
Q

What is Acidosis ?

A

Low blood and tissue PH

29
Q

What is hypoxemia?

A

Low 02 in the blood

30
Q

What is hypoxia ?

A

Low 02 in the tissue and the blood

midwifery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions