Week 114 - Pregnancy Flashcards
Pregnancy: Which two muscles make up the inside walls of the pelvis?
The piriformis and the obturator internus.
Pregnancy: The pelvic floor can be divided into which two triangles?
Anal triangle and urogenital triangle.
Pregnancy: What is the arbitrary line that divides the anal triangle and the urogenital triangle?
A line between the ischial tuberosities.
Pregnancy: Which two groups can the muscles of the urogenital triangle be divided into?
Deep and superficial.
Pregnancy: Which muscles make up the deep group of the urogenital triangle?
Bulbospongiosus, ischiocavernosus and superficial tranverse perineal muscles.
Pregnancy: Which muscles make up the superficial group of the urogenital triangle?
Deep tranverse perineal muscles and urethral sphincter.
Pregnancy: Which two layers of fascia separate the deep and superficial groups of the urogenital triangle?
The superior fascia and the perineal membrane.
Pregnancy: Which two muscles make up the anal triangle of the pelvic floor?
Levator Ani and coccygeus.
Pregnancy: The levator ani is the most important muscle in the pelvic floor, what three parts is it made up of?
- Pubococcygeus
- Ischialcoccygeus
- Puborectalis
Pregnancy: What are the four functions of the levator ani?
1) Forms a muscular sling for supporting the abdominopelvic viscera.
2) Resists increases in intra-abdominal pressure.
3) Raises the pelvic floor to assist in compression of the pelvis and abdomen.
4) Assists in voluntary control of urination, faecal continence and defaecation.
What is the graphical representation of the progression of labour called?
A Partogram.
A partogram is the graphical representation of the progression of labour, what information does it have on it?
- Dilation of the cervix against time.
- Contractions
- Foetal heart rate.
- Liquor
- Moulding
- Descent.
What is full dilation of the cervix?
10cm
During labour at which rate of dilation is desired?
1cm/hr. However, the nice guidlines state 0.5cm/hr.
What is the maximum amount of contractions that is desired?
No more than 5 per 10min.
What is the range of a normal foetal HR?
110-160
What is liquor?
It is the amniotic fluid it should be clear but can be stained by meconium and turn pea green.
What is meconium?
It is the babies bowel movement.
What is the name of a babies bowel movement?
Meconium.
What drug can be administered to make contractions more regular and efficient?
Syntocinin (Synthetic oxytocin).
What drug can be administered to soften the cervix?
Prostin.
What is Prostin used for during labour?
To soften the cervix.
What is moulding?
This is the overlapping of the parietal bones. There are three degrees; • No moulding • 2nd degree and • 3rd degree
What is 2nd degree moulding?
The parietal bones overlap but they can be slid back into position.
What is 3rd degree moulding?
This is when the parietal bones overlap and they cannot be moved.
How is descent of the foetus measured?
- This is known as the station of the head.
- The relation of the head to the ischial spines.
- When the head is level it is said to be zero.
- When the head is above it can be -1,-2,-3,-4cm
- When it is below it can be +1,+2,+3cm
What is the 1st stage of labour?
- From the onset of labour to cervix fully dilated.
- A) Latent - onset of labour to cervix fully effaced.
- B) Active - Cervical dilation
What is effacement?
Incorporation of the cervix into the lower segment of the uterus at the internal os.
What is the 2nd stage of labour?
Full dilation until delivery of the baby.
• A) Propulsive - full dilation > head to the pelvic floor.
• B) Expulsive
What is the 3rd stage of labour?
Expulsion of the placenta.
What is the method for controlled cord traction?
Brandt-Andrews method.
What is the mechanism of normal labour?
- Head is at pelvic brim in left occipital lateral position.
- Neck flexes so the presenting diameter is suboccipito-bregmatic.
- Head rotates to occipto anterior.
- Head delivers by extension.
- Head restitutes.
- Anterior shoulder slips under pubis and is born by lateral extension.
What is restitution?
This is the head comes into line with the shoulders.
What is caput?
The normal oedema of the scalp.
What is the lie of the baby?
This is the position of the baby in relation to the mothers spine.
• Longitudinal (in line)
• Oblique
• Transverse.
What is the presentation of a foetus?
This is the part of the foetus in the lower pole of the uterus.
• Cephalic
• Vertex-very top of head
• Breech
What is the attitude of the foetus?
This is the posture of the neck of the foetus; either flexion, deflexion or extension.
What is dystocia?
Slow labour.
What is operculum?
This is also known as a ‘show’. A blood stained mucus discharge that signifies the onset of labour in 2/3 women.
What are the advantages and disadvantages of being a primigravid?
- Unique psychological experience.
- Inefficient uterine action.
- Rupture of uterus virtually unknown.
- Risk of cephalopelvic disproportion and foetal trauma.
What are the advantages and disadvantages of being a multigrad?
- Uterine action efficient - dystocia is rare.
- Risk of uterine rupture.
- Disproportion and trauma are rare if mother has had a previous vaginal delivery.
At which point is the foetal head said to be engaged?
When there is no more than 2/5 palpable per abdomen.
What is the best position for a head to be in?
Direct Occipital Anterior
What is the measurement for foetal head in the DOA position?
Subocciptal-bregmatic - 9.5cm
What is the measurement for foetal head diameter when in DOP position?
Occipital-frontal diameter - 10.5-11.5cm.
What drug is used for post-partum haemorrhage?
Ergometrine.
Which drug is given for the active management of the third stage of labour?
Syntometrine.
What is the name of the scoring system used to assess the health of the baby after it has been delivered?
Apgar Scoring System.
What are the name of the lines that appear on a pregnant abdomen?
Striae Gravidarum
What is the name of the dark line down the middle of the abdomen that occurs in 3/4 of pregnancies?
Linea nigra
What scar is produced by a caesarian section?
Pfannenstiel incision
What is Naegles rule?
A method of calculating EDD depending on length of menstrual cycle.
• If 28 day cycle - Add 9 months and 1 week to LMP.
• If 35 day cycle - Add 9 months and 2 weeks to LMP.
What are the main symptoms of pre-eclampsia?
- Proteinurea
- High BP
- sometimes oedema.
What are the four components of the Quadruple test?
- BhCG
- uE3
- AFP
- Inhibin A
