Stages Of Labour Flashcards
Perineal injury cannot be prevented by
Routine episiotomy
It is associated with increased incidence of disruption of anal spinchters and rectal tears
Indications of episiotomy
Breech
Shoulder dystotia
Feral macrosomia
Operative vaginal deliveries
Persistent occipital posterio positions
How can we perineal tear
Avoid delivery by early extension
Deliver head in between contractions
Perform timely episiotomy when indicated not routinely
Most comm cause of cephalo pelvic disproportionate
Rickets in developing
Trauma in developed
Uterine tachysysstole
Uncoordinated uterine contractions > 6 in 10 minutes
Associated with late active phase dysfunction wer cervix is already 7cm dilated
Common in occipital posterior position
Wait and watch policy is indicated
Common in nulliparius female
Hypotonic uterine stimulation
Uterine contractions are inadequate
Associated with early active phase
More common in nummiparous
What is the line of management in the false labour pain a
And prolonged latent phase
Sedate and wait
How is false labour pain is differentiating from latent phase if
Therapeutic rest valla false labour pothadi
Latent phase confirmed Atama oxytocin Ishtar
Amniotomyis not useful
What is scar dehiscence
Maternal tachycardia
Fetal bradycardia
Hypotension
Uterine scare tenderness
Bleeding per avian
Hematuria
Iugr management
Wait for spontaneous expulsion
Forceps extraction is done only when it does not spontaneously
Arom is not recommending because of infection
C section is avoided
The best gym for elective delivery in patient’s with previous stillbirth is
39 weeks by induction or C-section
use for fetal growth restriction after 28 weeks
Kick counts
Anterpartum fetal surveillance
Support and reassurance
Best way to manage in the obstructed labour is
C section
Obstructed labour
Dehydration
Exhaustion
Tachycardia
Tachypnea
Per abdominal examination the uterus in obstructed area will be Lok
Thick, tender,tonically contacted
Lower uterine segment thin and strep
Bandl’s ring
The groove between up uterine segment and lower uterine segment
Seen and felt
Pervaginal findings of obstruction labour
Hot and dry vagina
Caput present
Moulding present
Hematuria presents or absent
Per a dome finding of obstructed labour
Thin and stretched lower uterine segment
Tender thick tonically contracted upper uterine segment
Bandl’s sign
Fetal distress
Suprapubic bulge as the bladder is compressed between pubic symphysis and fetal head
Manage me t of obstructed labour
Whether live or dead always c section
Never give oxytocin a shot
Dehydration correction and sepsis correction
Complications of obstructed labour
Rupture of uterus
7-14 vesicovaginal fistula
What part is affected in the over cutting of episiotomy
External anal spincter
How many degrees of perineal tear is present
First degree restricted to skin of fourchette
Second degree
Muscle of perineal body
Third degree
External anal sphincter
Forth
External anal sphincter plus anal mucosa
When the cord is prolapsed what is the immediate step of management
Cord prolapse
Baby alive
C section
Immediate vaginal delivery not possible
First aid like
Tendelberg position
Posture exaggerate and elevated sims
Bladder fillin
What is schroeders constriction ring
Due to I coordinated uterine action when there is localised spastic contractions of sting of circular muscle fibre of uterus
Most common cause of non engagement of at term
Deflected head
Then cephalopelvic disproportion
Problems of prolonged. Labour
Infection
Ketosis
Obstructed labour
Danger of asphyxia
Latent phase is prolonged when
It exceeds more than 20 hrs
Nulli lo 20
Mukti lo 14
