OBS: Perinatal Medicine -- Abnormal Presentation and Position

Question 1

How to describe a CTG?

Answer 1

CTG of XXX is taken on (date) at (time)
The baseline FHR is … bpm, which is normal / indicates brady-/tachycardia, with increased/moderate/decreased variability. There are … accelerations and … decelerations. There is normal/hypertonic/hypotonic uterine activity.
This CTG is abnormal/normal.

Question 2

Management of cord prolapse

Answer 2

1. if vaginal delivery is imminent Expedite delivery by instrumental delivery
2. Minimise cord compression
   
   1. Elevation of fetal presenting part
      
      1. Manually pushing up fetal presenting part with fingers
      2. Trendelenburg / Head-down position
      3. Knee-chest position
      4. Distending maternal urinary bladder
   2. Tocolytics
3. Minimise vasoconstriction
   
   1. Avoid unnecessary manipulation of prolapsed cord
   2. if exposed outside vagina Wrap it with warm & moist pads
4. Urgent CS
   
   1. if cervix fully dilated & fetal presenting part engaged Vaginal delivery

Question 3

How to access fetal hypoxic status after delivery?

Answer 3

By APGAR score