114 - Pregnancy

Question 1

What does G1P0 mean?

Answer 1

Primigravida

G1 = 1st pregnancy
P0 = no children

Question 2

What does G5P1 ^+3

Answer 2

Multigravida

G5 = 5th pregnancy
P1 = one baby born
^+3 = 3 lost before 24 weeks (ectopic, termination, miscarriage)

Question 3

What do you write to express someones pregnancies if they are post menopausal/not pregnancy?

Answer 3

Just P3

Question 4

What is a term pregnancy?

Answer 4

37-42/52 weeks

Question 5

What is a partogram?

Answer 5

A graphic representation of progress in labour

Question 6

What does a partogram show?

Answer 6

Fetal HR
Liquor
Moulding
Decent of head
Oxytocin
Contractions per 10 min
Cervix diabeter

Question 7

What is the scar you get from a normal CS/

Answer 7

Pfannensteil

Question 8

What is striaw gravidarum?

Answer 8

Stretch marks

Question 9

Linea negra

Answer 9

Dark line down midline

Question 10

When is a babies head engaged?

Answer 10

When the majority of head is in the pelvis, when 2/5, 1/5 or 0/5 fifths are palpable per abdomen.

Question 11

What is the normal position of the fetal head?

Answer 11

In relation to the mother

Normal = DOA - Direct occipital anterior

Question 12

What is ‘face to pubes’?>

Answer 12

DOP

Question 13

What is the fetal diameter of the head in DOA and DOP?

Answer 13

DOA = Suboccipital bregmatic = 9.5cm

DOP = Occidental frontal = 10.5-11.5cm

Question 14

What is the station of the fetal head?

Answer 14

Where in relation to the ischial spines

-1 = 1cm above
0 = at level
+1 = 1cm below
+3 -> delivery

Question 15

How many stages are there in labour? What are they vreifly?

Answer 15

3

1) Onset of labour
2) Full dilation - delivery of baby
3) Delivery - expulsion of placenta + membranes

Question 16

What occurs in the 1st stage of labour?

Answer 16

Latent - contractions to the cervix is fully effaced (shortens )
Active - Cervix dilates at the external os

Question 17

What occurs in 2nd stage of labour?

Answer 17

Propulsive: from full dilation (10cm) to head reaching pelvic floor

Expulsive - irresistible desire to bear down/push to deliver the baby

Question 18

What occurs in the 3rd stage of labour?

Answer 18

The cord lengthens, there is a gush of blood, the fundus of the uterus rises

Question 19

How do you deliver the placenta?

Answer 19

CCT- controlled cord traction

• pull cord to help bring placenta out

use the Brandt-Andrews method, with hand on abdo to stop uterus inverting.

Question 20

What is the operculum?

Answer 20

A show - blood stained mucous discharge

Question 21

What difficulties can a primigravida have in childbirth?

Answer 21

Unique psychological experience
Insufficient uterine action
Risk of cephalopelvic disproportion

Question 22

What difficulties can a multigravida have in childbirth?

Answer 22

Risk of uterine rupture - due to hormones from previous preganancy

Question 23

Describe the route of the baby in labour

Answer 23

Head decends at pelvic brim LOL
NEck flexes
Head hits pelvic floor and rotates DOA
Head decends and delivers by extension
Head restitutes
Shoulders rotate (anterio-posterior diameter)
Anterior shoulder slips under the pelvis
Born with lateral flexion

Question 24

Which drugs are used during labour?

Answer 24

Syntocin
Ergometrine
Syntometrine

Question 25

What is/does syntocinon do?

Answer 25

It is synthetic oxytocin

• rhythmical uterine contractions
  Acts in 2 minutes if given IM

Question 26

What does ergometrine do?

Answer 26

Causes sustained, tetanic contractions

Used in PPH (postpartum haemorrage)

Acts in 40s, 30 mins activity

Question 27

What does syntometrine do?

Answer 27

For active management of 3rd stage
reduces blood loss
Quicker placental delivery
Everyone in UK given

Question 28

What is used in post partum haemorrhage every 15mins intramuscularly up to maximum of 8 doses.

Answer 28

Carboprost (15 alpha-methyl prostaglandin)

Question 29

What do they use Prostin (dinoprostone)

for?

Answer 29

Ripen the cervix.