T5: Dysfunctional Labor

Question 1

version

Answer 1

Þ Must be guided by ultrasound, and they will externally rotate the baby to vertex

Question 2

if a version is successful

Answer 2

they will order an abdominal binder or induce the mother

Question 3

if a version is unsuccessful

Answer 3

schedule a c-section

Question 4

Castor oil

Answer 4

folk belief because it increases peristalsis, and it can cause uterine contractions due to the close proximity

Question 5

labor inductions: prostaglandin

Answer 5

gel or CERVIDIL (looks like a tampon) and it goes by the cervix and stays in for 12 hours
o Causes cervix to ripen (soft and effaced) then they will use Pitocin

Question 6

labor inductions: balloon catheters

Answer 6

Cook’s catheter; one goes in the cervix and other one is outside the cervix, this causes mechanical traction by pulling on it
o When this falls out, the mom will be 3-4 cm dilated
o This is the only induction method for a TOLAC

Question 7

labor inductions: laminaria

Answer 7

insert sticks into the cervix

Question 8

labor inductions: amniotomy

Answer 8

artificial rupture of membrane (using an amniotic hook)

Question 9

when can an amniotomy not be used

Answer 9

if baby is -1-2 station

Question 10

labor inductions: pitocin

Answer 10

stimulates uterine contractions must be on a pump, and it is increased slowly, licensed personnel must also check Pitocin

Question 11

Augmentation

Answer 11

-Oxytocin
-Ambulation helps baby head move down and rotate
o Gravity helps
-Relaxation

Question 12

Vacuum-assisted birth

Answer 12

An obstetric procedure used to assist in the birth of a fetus by applying suction to the fetal head with a soft suction cup attached to a suction bottle (pump) by tubing and placing the device against the occiput of the fetal head.
(baby head must be very low +2 station)

Question 13

Vacuum-assisted birth: pop-off

Answer 13

vacuum becomes loose off baby head, after 3 pop off, they will have to do a c-section

Question 14

cesarean birth

Answer 14

Birth of the fetus through a transabdominal incision of the uterus

Question 15

Indications for C-Section

Answer 15

CPD (cephalic pelvic disproportion), malpresentations - Breech, face or brow, transverse, placental abnormalities, dysfunctional labor, umbilical cord prolapse, fetal distress, multiple births

Question 16

Classical incision (up and down cut) must ALWAYS BE

Answer 16

C-SECTION BIRTH because risk for uterine rupture is increased

Question 17

TOL

Answer 17

trial of labor

Question 18

TOLAC

Answer 18

trial of labor after cesarean

Question 19

VBAC

Answer 19

vaginal birth after cesarean

Question 20

meconium aspiration syndrome

Answer 20

abnormal inhalation of meconium (first stool) produced by a fetus or newborn

Question 21

meconium passage

Answer 21

passing of first stool

Question 22

If baby is vigorous with a meconium aspiration

Answer 22

baby is okay

Question 23

If baby is lethargic with a meconium aspiration

Answer 23

baby needs to be intubated with ET tube and deep suctioning is done

Question 24

shoulder dystocia

Answer 24

head is delivered but body/shoulder is stuck, OBSTETRICAL EMERGENCY

Question 25

Prolapsed cord

Answer 25

cord is in our outside vagina

Question 26

prolapsed cord intervention

Answer 26

-Keep fingers inside to prevent presenting part from pushing on the cord
-Knee to chest or Trendelenburg

Question 27

uterine rupture

Answer 27

• There is A LOT OF BLOOD
• You will not be able to palpate baby because bay is in abdomen you will not be able to feel contraction or find FHR

Question 28

amniotic fluid embolus/anaphylactoid syndrome of pregnancy

Answer 28

Amniotic fluid containing particles of debris enter maternal circulation
o HAIR, VERNIX, AMNIOTIC FLUID WITH RUPTURE OF MEMBRANE AND CAN GET INTO MOM CIRCULATION

Question 29

if mom survives amniotic fluid embolus/anaphylactoid syndrome of pregnancy …

Answer 29

she may have circulatory collapse, hemorrhage and DIC THIS MUST BE RECOGNIZED BECAUSE THEY CAN GOIN TO RESPIRATORY COLLAPSE