Twins, breech, shoulder dystocia Flashcards
1
Q
Maternal risk factors for shoulder dystocia
A
- Abnormal pelvic anatomy
- GDM
- Short stature
- Previous shoulder dystocia
2
Q
Foetal risk factors for shoulder dystocia
A
- Post-dates
* Macrosomia
3
Q
Labour-related risk factors for shoulder dystocia
A
- Instrumental delivery
- Abnormally long active phase of 1st stage
- Abnormally long 2nd stage
4
Q
HELPERR mnemonic for management of shoulder dystocia
A
- Help
- evaluate Episiotomy
- Legs
- Pressure
- Enter maneouvre (move foetus from inside)
- Remove posterior arm
- Roll onto all 4s
5
Q
Why is foetal hypoxia a potential complication of shoulder dystocia
A
Risk of umbilical cord compression between foetal body and maternal pelvis
6
Q
Maternal complications of shoulder dystocia
A
- PPH
- Rectovaginal fistula
- Symphyseal separation
- 3rd or 4th degree episiotomy
- Uterine rupture
7
Q
Foetal complications of shoulder dystocia
A
- Brachial plexus palsy
- Clavicle fracture
- Humerus fracture
- Foetal death
- Foetal hypoxia
- Cerebral palsy
8
Q
List the 4 types of twins
A
- Dizygotic
- Monozygotic DCDA
- Monozygotic MCDA
- Monozygotic MCMA
9
Q
When should external cephalic version be offered for breech
A
After 36 weeks if nulliparous
After 37 weeks if multiparous
10
Q
Absolute contraindications to ECV
A
- multiple pregnancy
- ruptured membranes
- recent bleed within 7 days
- abnormal CTG
- Major uterine anomaly
