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4th Year Reproduction > Normal and Abnormal Labour > Flashcards

Normal and Abnormal Labour Flashcards

1
Q

What is malposition?

A

Abnormal positions of the vertex of the fetal head relative to the maternal pelvis

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2
Q

What is the normal position of the fetal head?

A

Occipitoanterior

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3
Q

What is the vertex of the fetal skull?

A

The vertex is the area midway between the anterior fontanel, the two parietal bones and the posterior fontanel. A vertex presentation occurs when this part of the fetal skull is leading the way.

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4
Q

Fit these terms to the arrows:

  • The vertex
  • The flexion point
  • Anterior fontanelle
  • Posterior fontanelle
  • Parietal bone
  • Parietal eminance
  • Frontal bone
  • Coronal suture
  • Saggital suture
A
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5
Q

What is malpresentation?

A

Any presentation other than vertex

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6
Q

Name these types of presentation

A
  1. Complete breech - legs folded with feet at the bottom
  2. Footling breech - one or both feet point down and emerge first
  3. Frank breech - legs point up so bottom emerges first
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7
Q

What anatomical landmark is station 0?

A

Ischial spine

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8
Q

What is the definition of presentation

A

Which anatomical part of the fetus is closest to the pelvic inlet (leading)

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9
Q

What is the definition of attitude

A

Relationship of the fetal head to its own spine - should be flexed

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10
Q

What is the definition of position

A

The relation of the occipit to the maternal pelvis

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11
Q

What is the definition of lie

A

Relationship of the baby’s spine to the maternal spine

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12
Q

What does presence of muconium in the amniotic fluid indicate?

A

Fetal distress

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13
Q

What is the definiton of bradycardia on a CTG?

A

15 beats below the baseline for 3 minutes or more

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14
Q

What is the definition of a deceleration?

A

A drop of 15 beats or more below the baseline for more than 15 seconds

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15
Q

What are the indications for instrumental delivery?

A
  • Maternal exhaustion
  • Prolonged labour
  • Co-morbidities that make pushing dangerous
  • Fetal distress
  • Malposition
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16
Q

What is the difference for future pregnancies between a lower and upper uterine segment incision?

A

Lower segment incision = can still have vaginal deliveries

Upper segment incision = must only deliver in future via c-section

17
Q

What are the 3 Ps of abnormal labour?

A
  1. Passenger (doesn’t rotate/large baby etc)
  2. Passage (small pelvis)
  3. Power (tightenings not contrations/dehydration/epidurals etc)
18
Q

What is considered full term?

A

37 weeks

19
Q

What is the 1st stage of labour?

A

1st stage:

  • Latent phase = cervical dilation up to 3-4cms
  • Active phase = cervical dilation 4-10cm and contractions are regular and painful (about 4 in 10)
20
Q

What is the second stage of labour?

A

Passage through birth canal to delivery of baby. An hour for passive descent and then actively push. Prims can have up to 4 hours be considered normal.

21
Q

What is the 3rd stage of labour?

A

Delivery of baby to expulsion of placenta

22
Q

What is syntocinon?

A

An IV infusion of synthetic oxytocin - to help labour progress

23
Q

What should you do first if there is fetal distress?

A

Stimulate baby’s head/change Mum’s position etc to see if you can get a response and if not, take a fetal gas

24
Q

When is thrombin given in obstetrics?

A

During PPH if the bleeding is becoming very watery and you’re worried about PPH

25
Q

What uterotinic agents can be given in PPH?

A
  • Syntocinon
  • Mysoprostil
  • Carboprost (be careful is asthmatics)
  • Ergometrin (be very careful if patient is hypertensive)

+ 1g tranexamic acid (not uterotonic)

26
Q

What are indications for induction of labour?

A
  • Post dates
  • Ruptured membranes
  • Diabetic/hypertensive with poor control
  • Static growth
27
Q

What do you use instead of prostaglandins if a patient has had a previous c-section or is para 4+?

A

Cooks ballon

28
Q

What does Dr C Bravado stand for?

A

DR = Determine Risk (low or increased)

C = Contractions (how many in 10)

BRA = Baseline RAte (is there a tachy or bradycardia or rising baseline)

V = Variability (normal, reduced or absent)

A = Accelerations (present or absent)

D = Decelerations (absent, early, variable or late)

O = overall assessment and written plan (reassuring or non-reassuring)

29
Q

What is the expected rate of dilation?

A

2 cm every 4 hours

30
Q

What are the risk factors for shoulder dystocia?

A

Previous shoulder dystocia

Diabetes

BMI > 30

Induced labour

Prolonged labour

Intrumental delivery

31
Q

What drug can cause hyperstimulaton and issues with contractions which can lead to fetal distress

A

Syntocinon

4th Year Reproduction (5 decks)

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