Obs - Labour

Question 1

what is the bishops score?

Answer 1

used to assess cervix and determine outcome of labour

Question 2

what are the bishops scores used as boundaries?

Answer 2

≥9 will start without induction

5≤ will require induction

Question 3

what is the first line method of inducing labour? how long does it take to work?

Answer 3

membrane sweep

48hrs

Question 4

what medications can be used to induce labour? contraindications?

Answer 4

vaginal prostaglandin pessary

Hx of uterine scarring

Question 5

do misoprotol/mifepristone have a role in labour induction?

Answer 5

only where fetal death has occurred

Question 6

what infusion can be given to induce labour?

Answer 6

syntocinon infusion (often alongside artifical membrane rupture)

Question 7

what would be indications for induction?

Answer 7

macrosomia
pre eclampsia
premature ROM
reduced fetal movements

Question 8

when is an artifical rupture of membranes done?

Answer 8

cervix 2cm dilated

head engaged

Question 9

what does syntocinon do?

Answer 9

induce labour + contractions

Question 10

what does ergometrine do?

Answer 10

contractions

Question 11

what does syntometrine do?

Answer 11

induce labour + contractions

Question 12

what do vaginal prostaglandins do?

Answer 12

induce labour

Question 13

what anaesthetic options do women have during labour?

Answer 13

entonox
epidural
pudendal (ischial spines for op vaginal)
spinal (not commonly)

Question 14

what non pharmacological anaesthetic options do women have during labour?

Answer 14

TENS

water immersion

Question 15

what are the layers of the spinal cord? where does an epidural go?

Answer 15

dura (below this)
arachnoid
pia

Question 16

what are complications of an epidural?

Answer 16

headache
back pain
atonic bladder
hypotension
abnormal fetal HR
inhibit stage 2

Question 17

what is failure to progress in the 1st stage classified as?

Answer 17

<2cm in 4hrs

Question 18

what is failure to progress in the 2nd stage classified as?

Answer 18

> 3hrs with anaesthetic/>2 without

>2hrs ‘’, >1 (multi)

Question 19

what is the maximum length of time for the 1st stage?

Answer 19

12 in nulparous

10 in primi

Question 20

when is doppler of fetal heart done during 1st/2nd stage of labour?

Answer 20

1st - every contraction, every 15 mins

2nd - every contraction, every 5 mins

Question 21

when is the 3rd stage of labour delayed?

Answer 21

> 30mins active

>60 mins physiological

Question 22

options for active management of the 3rd stage?

Answer 22

synometrine
oxytocin
bladder catheter
cord clamping

Question 23

when is an operative delivery indicated?

Answer 23

delay in stage 2
fetal distress
pre/eclampsia
haemorrhage
maternal CVS
umbilical cord prolapse

Question 24

whats better, ventouse or forceps?

Answer 24

forceps

Question 25

when is a c section indicated?

Answer 25

previae
abruption 
pre eclampsia
fetal distress
cord prolapse
vasa previae
failure to progress

Question 26

what are the 4 classifications of c section?

Answer 26

1 - immediate threat to life (30 mins)
2 - maternal/fetal compromise (30-75mins)
3 - no compromise
4 - timed to suit women

Question 27

what Abx are given with a c section?

Answer 27

co amox (+amox if BMI >30)