Shoulder, C-section, Haemorrhage Flashcards
When does shoulder dystonia happen?
When bone gets stuck on bone,
Unique to cephalosporins presentation
Shoulder dystocia signs?
Chin retracts: turtle sign
Anterior shoulder doesn’t birth with normal traction
When does Shoulder dystonia happen?
50% unknown
50% Macrosomia, post term, DM2
Don’t do what in Shoulder dystonia?
Don’t rotate fetal head
Avoid excessive traction
Avoid fundal pressure
Management of Shoulder dystonia?
Robertson Maneuvre +
Suprapubic pressure
Shoulder dystonia internal procedure?
Remove Posterior Arm
Shoulder dystonia complications?
Brachial plexus
Fracture of clavicle or humerus
Asphyxia
Death
Peri mortem C-section benefits who?
Save the mother.
2 major reasons for caesarean section Intrapartum?
Failure to progress
Presumed fetal compromise
Prep for Caesarean section?
Consent Left lateral tilt OT, a aesthetics, padiatrician IDC Confirm fetal presetation and heart beat Abx - preincision ideally
Post operative care of Caesarean section?
Analgesia VTE Lactation Mobilization IV fluids Bladder Care Physio Wound care Debrief
Caesarean section increases risk of what in placenta?
Placenta Previa, accreta
Primary risk of vaginal birth after Caesarean section? (VBAC)
Uterine rupture 5-6% chance of fetal death
VBAC requirements?
Singleton cephalothorax
Continuous moniting
Immediate access to theatre
Why not induce or augment VBAC?
Increase risk of uterine rupture
Antepartum haemorrhag def’n?
Bleeding from or into the genital tract between 20weeks of gestation until onset labour
What to look for in Antepartum haemorrhage?
May be concealed
Look for SHOCK
Partner violence for Antepartum haemorrhage how present?
Small volume and repeated presentations
Sensitive and explicit asking
Placental adhesion disorders
Accreta: adhered to myometrium
Increta: into but not through myometrium
Percretaincreta: through myometrium to bladder
If placenta praevia, don’t do what? What can do?
DON’T do digital exam
DO speculum visualization
Local causes of Antepartum haemorrhage?
Cervical E tropics
Malignancy
Cervicitis
Trauma (post coital)
Vasa praevia risk to who?
Fetus
How to tell vasa praevia in U/S
Doppler to see if it’s fetal Heat beat
Antepartum haemorrhage when emergency?
Haemodynamic compromise
Antepartum haemorrhage management?
Elective C-section
