Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics & Gynaecology > The normal labour > Flashcards

The normal labour Flashcards

1
Q

What are Braxton Hicks contraction?

A

‘Practice’ contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do Braxton Hicks contractions occur?

A

From first trimester, but most commonly after 36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do Braxton Hicks contractions differ from real contraction?

A

1) Infrequent (and do not increase in frequency as with real contractions)
2) Irregular
3) Of low intensity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mnemonic for the signs of labour?

A

Ready
Mom for
Some
Discomfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the signs of labour?

A 
R = regular, painful contraction
M = membrane rupture
S = 'show', i.e. a mucus plug
D = dilation and effacement of the cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the mechanical factors that determine the progress of labour?

A
  1. Power - force of contractions
  2. Passage - dimensions of pelvis and resistance of soft tissues
  3. Passenger - diameters of the foetal head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many stages of labour are there?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the different phases of the first stage of labour?

A

Latent phase and established phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What defines the latent phase?

A

Contractions and effacement and dilation to 4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What defines the established phase?

A

Contractions and dilation >4cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the different phases of the second stage of labour?

A

Passive stage and active stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What defines the passive stage?

A

Complete cervical dilation, but no desire to push

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What defines the active stage?

A

Infant seen, and expulsive contractions, and maternal effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In the established phase, what is a satisfactory rate of dilation from 4cm?

A

0.5cm/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What defines weak contractions?

A

<20 seconds long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What defines moderate contractions?

A

20-40 seconds long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What defines strong contractions?

A

> 40 seconds long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 2 forms of intermittent foetal heart monitoring?

A
  1. Pinard’s stethoscope

2. Hand-held doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the forms of continuous foetal heart monitoring?

A
  1. External - CTG

2. Internal - foetal scalp electode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the advantages of CTG?

A
  1. Visual record
  2. High sensitivity for foetal distress
  3. Reduction in short-term neurological morbidity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the disadvantages of CTG?

A
  1. Decreased maternal mobility
  2. Increased rate of obstetric intervention
  3. More puerperal sepsis
  4. No proven reduction in mortality or long-term handicap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the attitude of the head?

A

The degree of flexion of the head on the neck

23
Q

What is the ideal attitude of the head?

A

Maximum flexion = vertex presentation

24
Q

What does 0 mean with regard to moulding?

A

Bones are separated and sutures can be felt easily

25
Q

What does +1 mean with regard to moulding?

A

Bones are just touching each other

26
Q

What does +2 mean with regard to moulding?

A

Bones overlapping but CAN be separated easily by finger

27
Q

What does +3 mean with regard to moulding?

A

Bones overlapping and cannot be separated easily with finger

28
Q

Why should a woman be discouraged from lying in the supine position during the second stage of labour?

A

IVC compression

29
Q

What is the active management of the third stage of labour?

A

Routine use of uterotonic drugs (oxytocin)
Deferred clamping and cutting of cord
CCT after signs of placenta separation

30
Q

What is the physiological management of the third stage of labour?

A

No routine use of uterotonic drugs (oxytocin)
No clamping of cord until pulsation has stopped
Delivery of placenta by maternal effort only

31
Q

What are the advantages of using uterotonic drugs in the third stage of labour?

A
  1. Decreases the third stage time to approx. 5 minutes
  2. Decreases the incidence of PPH (and decreases the need for blood transfusion)
  3. Lower rates of N&V
32
Q

What are the disadvantages of using uterotonic drugs in the third stage of labour?

A
  1. Poses an issue for undiagnosed twins
33
Q

What are the signs of placental separation?

A
  1. Cord lengthening
  2. Rush of blood
  3. Uterus rises
  4. Uterine contraction
34
Q

What defines a 1st degree tear?

A

Skin injury only

35
Q

What defines a 2nd degree tear?

A

Perineal muscle involvement, NOT anal sphincter

36
Q

What defines a 3rd degree tear?

A

Anal sphincter involvement (3a = <50% external sphincter involvement; 3b = >50% external sphincter involvement; 3c = external AND internal anal sphincter involvement)

37
Q

What defines a 4th degree tear?

A

Anal sphincter AND anal epithelial involvement

38
Q

What are the non-pharmacological methods of analgesia used in labour?

A
  1. Breathing exercises
  2. Relaxation/massage techniques
  3. Warm water immersion
  4. Birthing pools
39
Q

What are the pharmacological methods of analgesia used in labour?

A
  1. Inhalational - Entonox
  2. IM - pethidine; diamorphine; metpid
  3. Regional - epidural; CSE; spinal; pudendal
40
Q

What is Entonox mad up of?

A

Equal mix oxygen and nitrous oxide

41
Q

What are the S/Es of IM opiates?

A
  1. Sedation/drowsiness (should not be in birthing pool/bath within 2 hours of administration)
  2. Confusion
  3. Respiratory depression in newborn
42
Q

What is an epidural?

A

AN injection of LA into the epidural space, anaesthetising pain fibres carried by T11-S5

43
Q

Where should an epidural injection be carried out?

A

Between L3 and L4

44
Q

Through what ligament does the epidural need have to pass in order to reach the epidural space?

A

Ligamentum flavum

45
Q

What are the advantages of epidurals?

A
  1. Most effective analgesic method

2. Prevent premature pushing

46
Q

What are the disadvantages of epidurals?

A
  1. Increased supervision required
  2. Maternal fever
  3. Decreased mobility which can = pressure sores
  4. Increased instrumental delivery rate
  5. Hypotension
  6. Urinary retention
47
Q

What are the complications of epidurals?

A
  1. Spinal tap - inadvertent puncture of the dura mata, causing CSG leak and severe headache
  2. Total spinal anaesthesia - inadvertent injection into the CSF causing respiratory paralysis
  3. Local anaesthetic toxicity
48
Q

What are the contraindications to epidural?

A
  1. Sepsis
  2. Coagulopathy
  3. Anticoagulant therapy
  4. Active neurological disease
  5. Spinal abnormalities
  6. Hypovolaemia
49
Q

What is CSE?

A

Combined spinal epidural

50
Q

How does CSE differ from a ‘standard’ epidural?

A
  1. More rapid than ‘standard’ epidural

2. Little/no blockade - e.g. allows for standing/walking/urine voiding etc.

51
Q

What is the analgesia method-of-choice for instrumental delivery (but not rotational forceps)?

A

Pudendal

52
Q

What is the analgesia method-of-choice for C-section?

A

Spinal

53
Q

What are the complications of spinal anaesthesia?

A
  1. Hypotension

2. Total spinal anaesthesia

54
Q

Where is the LA injected in spinal anaesthesia?

A

Into the CSF

Obstetrics & Gynaecology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions