Peripartum: Vaginal birth, Induction and Caesarean section Flashcards
Peripartum lecture
What are the stages of labor?
Onset of labor:
When does it occur? how?
Diagram explanantion of chemical activity fetus+mother in labor
What is oxytocin? Function?
Prostaglands? (in labor?
Estrogen? (in labor)
Progress of label:
Partogram- What is it?
Movement of baby throouggh uterus:
Head floating: Before engagement-
Normal labor?
Why do women need induction?
List reasons?????
2 Stages cervical rippening
1) Post term
Methods of induction:
2 stages:
1) Cervical rippening
2) Artificial rupture of membranes
When might an assisted vaginal birth be required? List:
- 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)
When else might an assisted vaginal birth required? (fetus)
- Occiuptoanteriror is the best position for fetus in labor
Newborn skull: Known anatomy:
Instruments of labor:
Forceps:
Vacum?
Types of forceps and their anatomy:
Direct traction?
Traction
- manoureves
Risks and complications of instruments delivery:
Maternal risks?
Fetal risk?
What is a ventouse:
Correct placement of ventouse:
What are the major risk and complications to foetus with instrumental delivery?
C-section
History:
Rates and statistics:
C section rates increasing
When is C section indicated? (maternal factors)
Fetal indications for C section?
List 6
Maternal risks - C section:
Fetal - Risks to c section:
Management of pt- Post labour: Give 6 points:
Contraindications to vaginal birth?
What do you need to explain in consenting a patient for c-section:
Neonatalogy:
Problems of prematurity Theme:
Defintions:
Prematurity? Birth weight? Viability?
What is the definition for prematurity?
Local guidelines around viability: Early weekers (24 weekers etc)
Explanation of babys at 23 weeks, 24 weeks, 25 weeks, 26 weeks (babies born very early)
- Severe disability- non indepe
Potential probelsm of prematurity:
Why are babies born premature?
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
What issuse occur due to premature birth?
Neruo- Short term (very fragile BVs before birth)
- Interventricular bleed
- IVH
- all babies get USS to look for this
Intraventrciular haemorrhages-
Occur with preterm babies:
Occurs commonly in cerebral palsy-
Neuro:
- Can turn to hydrocephalesu
- longer term- PVL (periventiruclar leukooplacia)
*
Resp complications:
Surfactant
Surfactant- decreases surface tension (also known as respiratory distress/hyaline- ground glass appearance-frosted window)
Thus- Surfactant deficency very common under 30 weeks
Resp complications- medium term- Associated with children that are on ventilators for a long time:
Resp complications: Long term- LCD
Interstial changes: NLD- Bronchopulmonary dysplasia
Prematurity: Blood supply: PDA - stays open for longer - can cause HF - pulmonary oedema
Tx - Paracetomol closes the duct
Prematurity: Gastrointestinal changes:
What is necrotizing entercolitis?
- 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
NEC?
Image features
- Tram track
- Can commonly get air under and up into liver
- very sick -
Prematurity: Eyes:
Retinopathy of prematurity-
Prematurity- Hearing
Growth and development in premature babies:
Failure to thrive is common in premature children:
