Vaginal Delivery Flashcards
What type of delivery has the lowest risk of maternal comorbidity?
Vaginal delivery
What is the most common and satisfactory position during delivery?
Dorsal lithotomy position
What is the most common position of baie sin cephalic position?
Occiput anterior
What is the the encirclement of the largest head diameter by the vulvar ring?
Crowning
How to prevent spontaneous vaginal lacerations?
Antepartum/Intrapartum Perineal Massage
-> 34-35 weeks AOG
Insert 1 or 2 fingers 3cm into the vagina then apply
Downward pressure for 2 mins & Laterally on each side for 2mins
What are the 2 maneuvers done to control acceslerative forces in order to slow deliveryof the head?
Modified ritgen maneuver = DONE if the power is inadequate
Hands-on method
What is the amt of degrees of lateral deviaiton of the neck?
25-45 degrees
Where do you clamp the umbilical cord?
2-3cm from its isnertion into the fetal abdomen
6-8cm from the fetal abdomen
When do you clamp the umbilical cord?
30-60 secs or until cord pulsation ceases
What are the benefits of proper timing of cord clamping?
Increase total iron stores
Expand blood volume
Decrease incidence of aneima
What are the benefits of delayed cord clamping in preterm neonates?
- Decreases rate of blood transfusion adn death before hospital discharge
- Prevents intraventricula rhemorrhage
What are the predisposing risk factors of persistent occiput posterior position?
Epidural anesthesia
Nulliparity
Greater fetal weight
Prior OP delivery
Anthropoid pelvis
Narrow subpubic angle
What is the Turtle sign?
One indicator may be retraction of the baby’s head against the mother’s perineum
What are the maternal consequences of dystocia?
Serious perineal tears
Postpartum hemoarrhage
What are the neonatal consequences of dystocia?
Neuromusculoskeletal injury
Asphyxia
At what AOG do u wait against induction for suspected macrosomia alone?
39 wees
What are the 2 maneuvers done to disipact anterior shoulder that is stuck at th e symphysis pubis?
- McRoebrts maneuver
- Mazzanti maneuver (abdomina approach)
- Rubin maneuver
What is the diff betw Rubin manuever and WOod’s screw maneuver?
Rubin = freeing impacted ANTERIOR shoulder by exerting pressure on the POSTERIOR aspect of the anterior shoulder
Wood’s screw = freeing POSTERIOR shoulder by exerting pressure on the ANTERIOR aspect of the posterior shoulder
What are the goals in third stage of labor?
Deliveryof intact placenta
Avoidance ofuterine inversion
Prevent postpartum hemorrhage
What is the expectant management during thirs stage of labor?
Nipple stimulation or by gravity = gush of blood suddenly, globular and firmer fundus, lengthening of the umbilical cord, elevation of the uterus into the abdomen
4-12 minutes
What are the active amnagemetn of 3rd stage of labor?
Early/delayed cord clamping
Controlled cord traction during placental delivery
Immediate prophylactic administration of a uterotonic agent
What aer the diff Uterotonics?
Oxytocin
Methylergonovine
Misoprostol
Carboprost
What are the immediate postpartum care?
1st hr after placental delivery
Placental and cord inspection
Vigilant monitoring for uterine atony and hemorrhage
Perineum must be inspected for alcerations and hematoma
What aer the factors favoring cesarean delivery of the breech fetus?
Lack of operator experience
Patient request for cesarean delivery
Prior perinatal death or neonatal birth trauma
What are the diff partial breech extraction?
Pinard’s maneuver
Lovset manuever
Mauriceau maneuver
Piper forceps
Modified prague maneuver
