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Obstetrics I - OSCE > Normal Labor (Pt2) > Flashcards

Normal Labor (Pt2) Flashcards

1
Q
A
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2
Q

Managment of Labor

  • 1st Stage
A
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3
Q

Management of 2nd stage of Labor

A
  • Before Head Delivery
  • Head Delivery
  • After Head Delivery
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4
Q

Management of 2nd stage of Labor

  • Before Head Delivery
A
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5
Q

Management of 2nd stage of Labor

  • position
A

Lithotomy position on delivery table.

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6
Q

Management of 2nd stage of Labor

  • Sterialization & Towelling
A

…

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7
Q

Management of 2nd stage of Labor

  • Evacuation
A

Evacuation of bladder & rectum.

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8
Q

Management of 2nd stage of Labor

  • Bearing Down?
A

Ask patient to bear down during uterine contractions only & relaxes () contractions.

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9
Q

Management of 2nd stage of Labor

  • Observation
A

Observations for maternal & fetal conditions.

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10
Q

Management of 2nd stage of Labor

  • Head Delivery
A
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11
Q

Aim in Head delivery

A

Decrease Perineal Lacerations

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12
Q

Head delivery

  • When to support Perineum?
A

As soon as head distends vulva, attendant supports perineum by closed fist of hand & pad of cotton

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13
Q

Head delivery

  • Why Support The Perineum?
A

to maintain flexion of head till crowning occurs (to ensure distension of vulva by the smallest diameter of fetal head).

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14
Q

Head delivery

  • Managment of Head Extension
A
  • If extension occurred before crowning (premature extension) → Increased diameter distending vulva → perineal tear.
  • After crowning, head is allowed to extend in () uterine contractions (not during uterine contractions) by Ritgen ‘s maneuver which means upward & backward pressure on perineum & downward pressure on occiput to allow gradual extension of head.
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15
Q

Head delivery

  • After Crowning
A
  • After crowning, head is allowed to extend in () uterine contractions (not during uterine contractions) by Ritgen ‘s maneuver
  • Which means upward & backward pressure on perineum & downward pressure on occiput to allow gradual extension of head.
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16
Q

Head delivery

  • Episiotomy
A

Episiotomy is done è crowning when it is indicated.

17
Q

Management of 2nd stage of Labor

  • After Delivery of Head
A
18
Q

Management of 2nd stage of Labor

  • Swabbing
A

Baby’s eyelids, mouth & nose are swabbed.

19
Q

Management of 2nd stage of Labor

  • Suction
A

Suction is done to clear airway starting by mouth then nose.

20
Q

Management of 2nd stage of Labor

  • Examination of Cord
A
  • Examination for any loop of cord coiled around neck: If coils of cord are present, do either slipping of coil or division of cord if tight) in () 2 clamps.
21
Q

Management of 2nd stage of Labor

  • Delivery of Shoulders
A
22
Q

Management of 2nd stage of Labor

  • Delivery of Trunk & rest
A

Easily

23
Q

Management of 2nd stage of Labor

  • Holding Newborn
A
  • Newborn is held from his feet è head down for few seconds to drain respiratory passage
24
Q

Management of 2nd stage of Labor

  • When to avoid Holding Newborns in upside down way?
A

Except in cases of

  • Prematurity
  • Asphyxia
  • Possibility for ICH
25
Q

Management of 2nd stage of Labor

  • Ligation & Cutting of Cord
A
26
Q

Management of 2nd stage of Labor

  • When to avoid milking Cord?
A

Cord is clamped immediately eout milking in the following conditions:

  • Premature baby: To avoid hypervolemia, HF & hyperbilirubinemia.
  • Rh isoimmunization: To Decrease Abs reaching neonate.
  • Diabetic mother: To avoid hypervolemia.
  • Multifetal pregnancy.
  • After general anesthesia: To anesthetic agents & get early recovery.
27
Q

Management of 2nd stage of Labor

  • Inspection of Lower Genital Tract & Perineum
A

For lacerations & tears.

28
Q

Managment of 3rd stage of Labor

A
29
Q

Managment of 3rd stage of Labor

  • Aims
A

1) Ensuring complete expulsion of placenta & membranes.
2) Prevention of PPH.

30
Q

Managment of 3rd stage of Labor

  • Methods
A
  • Conservative
  • Active
31
Q

Expectant Managment of 3rd stage of Labor

  • Method
A
32
Q

Expectant Managment of 3rd stage of Labor

  • Advantages
A

Safe

33
Q

Expectant Managment of 3rd stage of Labor

  • Disadvantages
A

Time consuming & more blood loss.

34
Q

Active Managment of 3rd stage of Labor

  • Method
A
35
Q

Active Managment of 3rd stage of Labor

  • Advantages
A

Decrease duration of 3rd stage —-> Decrease blood loss —–> decrease incidence of PPH.

36
Q

Active Managment of 3rd stage of Labor

  • Disadvantages
A

Obstetrics I - OSCE (32 decks)

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