Peripartum: Vaginal birth, Induction and Caesarean section

Question 1

Peripartum lecture

What are the stages of labor?

Answer 1

Question 2

Onset of labor:

When does it occur? how?

Answer 2

Question 3

Diagram explanantion of chemical activity fetus+mother in labor

Answer 3

Question 4

What is oxytocin? Function?

Prostaglands? (in labor?

Estrogen? (in labor)

Answer 4

Question 5

Progress of label:

Partogram- What is it?

Answer 5

Question 6

Movement of baby throouggh uterus:

Head floating: Before engagement-

Answer 6

Normal labor?

Question 7

Why do women need induction?

List reasons?????

2 Stages cervical rippening

Answer 7

1) Post term

Question 8

Methods of induction:

2 stages:

1) Cervical rippening
2) Artificial rupture of membranes

Answer 8

Question 9

When might an assisted vaginal birth be required? List:

Answer 9

• exhuastion of mother
• breech - position (because the compressible components of baby opposite)
• foetal distress
• Prolonged second stage ( greater than 2 hours)
• Cardiac conditions (severe mitral regurg)

Question 10

When else might an assisted vaginal birth required? (fetus)

Answer 10

• Occiuptoanteriror is the best position for fetus in labor

Question 11

Newborn skull: Known anatomy:

Answer 11

Question 12

Instruments of labor:

Forceps:

Vacum?

Answer 12

Question 13

Types of forceps and their anatomy:

Direct traction?

Answer 13

Question 14

Traction

• manoureves

Answer 14

Question 15

Risks and complications of instruments delivery:

Maternal risks?

Fetal risk?

Answer 15

Question 16

What is a ventouse:

Answer 16

Question 17

Correct placement of ventouse:

Answer 17

Question 18

What are the major risk and complications to foetus with instrumental delivery?

Answer 18

Question 19

C-section

History:

Answer 19

Question 20

Rates and statistics:

C section rates increasing

Answer 20

Question 21

When is C section indicated? (maternal factors)

Answer 21

Question 22

Fetal indications for C section?

List 6

Answer 22

Question 23

Maternal risks - C section:

Answer 23

Question 24

Fetal - Risks to c section:

Answer 24

Question 25

Management of pt- Post labour: Give 6 points:

Answer 25

Question 26

Contraindications to vaginal birth?

Answer 26

Question 27

What do you need to explain in consenting a patient for c-section:

Answer 27

Question 28

Neonatalogy: Problems of prematurity Theme: Defintions: Prematurity? Birth weight? Viability?

Answer 28

Question 29

What is the definition for prematurity?

Answer 29

Question 30

What about baby weights? Definitions:

Answer 30

2500 + normal 1500g \<1500g

Question 31

Local guidelines around viability: Early weekers (24 weekers etc)

Answer 31

Question 32

Explanation of babys at 23 weeks, 24 weeks, 25 weeks, 26 weeks (babies born very early)

Answer 32

* Severe disability- non indepe

Question 33

Potential probelsm of prematurity: Why are babies born premature?

Answer 33

1) infection (asymptomatic bactaraemia) 2) Multiple pregnancy 3) Twin to twin transfusions 4) Multiple pregnancy 5) Drug abuse - Amphetamine- Associated with preterm labor 6) Bacterial vaginosis 7) cervical insufficiency (LETTS/loops or short cervix) 8) Pre-clampsia - Another common cause

Question 34

What issuse occur due to premature birth? Neruo- Short term (very fragile BVs before birth)

Answer 34

* Interventricular bleed * IVH * all babies get USS to look for this

Question 35

Intraventrciular haemorrhages- Occur with preterm babies: Occurs commonly in cerebral palsy- Neuro:

Answer 35

* Can turn to hydrocephalesu * longer term- PVL (periventiruclar leukooplacia) *

Question 36

Resp complications: Surfactant

Answer 36

Surfactant- decreases surface tension (also known as respiratory distress/hyaline- ground glass appearance-frosted window) Thus- Surfactant deficency very common under 30 weeks

Question 37

Resp complications- medium term- Associated with children that are on ventilators for a long time:

Answer 37

Question 38

Resp complications: Long term- LCD

Answer 38

Interstial changes: NLD- Bronchopulmonary dysplasia

Question 39

Prematurity: Blood supply: PDA - stays open for longer - can cause HF - pulmonary oedema Tx - Paracetomol closes the duct

Answer 39

Question 40

Prematurity: Gastrointestinal changes: What is necrotizing entercolitis?

Answer 40

* premature babies too small - mostly fed by NG * IF very small- Gi has developed- needs TPN - as their All babies get probiotics- when they start food

Question 41

NEC? Image features

Answer 41

* Tram track * Can commonly get air under and up into liver * very sick -

Question 42

Prematurity: Eyes: Retinopathy of prematurity-

Answer 42

Question 43

Prematurity- Hearing

Answer 43

Question 44

Growth and development in premature babies: Failure to thrive is common in premature children:

Answer 44