Pregnancy And Labour Flashcards
What is a tocolytic?
Prevent preterm labour and immature birth by suppress uterine contractions
Name 6 classes tocolytics with examples.
- B2 agonists eg salbutamol, terbutaline
- oxytocin antagonists: atosiban
- CCB: nifedipine
- MgSO4
- NSAIDs: indomethacin
- Glyceryl trinitrate
Preferred tocolytic?
MgSO4
Antidote to MgSO4
Calcium gluconate
MgSO4 adverse effects (3)
- Respiratory depression and cardiac arrest , loss deep tendon reflexes
- hypotension dangerous with CCB
- flushing, nausea, headache, drowsy, blurred vision
Name 2 contraindications MgSO4
- Myasthenia graves
* heart block
Why are NSAIDs dangerous to use as tocolytics?
- Premature closure fetal ductus arteriosus
* necrotising enterocolitis
What is useful as emergency tocolytic?
Glyceryl trinitrate
What are oxytocics?
Induce labour by strengthen uterine contractions or control pp bleeding
Name 4 contraindications using tocolytics
- Intrauterine infections
- foetal distress
- Severe pre-eclampsia
- vaginal bleedin and other haemodynamic disturbances
Name 5 contraindications to using oxytocics
- Placenta previa
- abnormal foetal position and presentation
- umbilical cord prolapse
- pelvic structure defects mother
- herpes infection
Name 5 types oxytocics with examples
- Oxytocin
- ergot alkaloids:ergometrine
- prostaglandins: dinoprostone
- prostaglandin analogues: misoprostol
- progesterone antagonist:mifepristone
First line oxytocics?
Oxytocin.
Second line oxytocics
Ergometrine oxytocin combination
Indication progesterone antagonist as oxytocics?
Under supervision for early and mid-trimester aborsions to expel dead foetus.
