Brainscape's Knowledge GenomeTM

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


See full index

Reproduction and Sexual Health > Labour Complications > Flashcards

Labour Complications Flashcards

1
Q

what is the puerperium

A

period of recovery after birth when tissues return to pre-pregnancy state

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

describe the changes to maternal discharge in the post-partum period

A

days 3-4 fresh red blood
days 4-14 brown watery discharge
days 10-20 yellow discharge

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

after how long will the uterus have returned to its normal size of within the pelvis

A

2 weeks

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

what volume of blood loss is considered normal during labour

A

<500 ml

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

what is the difference between primary and secondary PPH

A

primary - within first 24 hours

secondary - after 24 hours but before 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a minor PPH is blood loss of how much

A

500-1000ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

a major PPH is blood loss of how much

A

> 1000ml or signs of collapse

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

what are the 4 main causes of PPH

A

tone - uterine atony
trauma - vaginal tear/cervical laceration
tissue - retained placenta or membranes
thrombin - coagulation disorder

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

what is the most common cause of PPH

A

uterine atony - failure of the uterus to contract following delivery

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

list some antenatal risk factors for PPH

A

placental problems such as praevia or accreta
past obstetric history of retained placenta, c-section
multiple pregnancy
polyhdramnios

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

list some obstetric risk factors for PPH

A 
operative vaginal delivery
use of syntocinon or syntometrine 
retained placenta 
c-section 
labour >12 hours 
perineal tear during delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the initial management of PPH

A

ABCDE
oxygen
IV access for G&S + crossmatch + FBC + coag screen
IV transexamic acid to stop the bleeding

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

how is uterine atony and retained placental products managed non-surgically

A

uterine massage with bimanual compression
5 units of IV syntocinon
if no response administer ergometrine or carboprost

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

what is carboprost

A

synthetic prostaglandin

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

how is a thrombin problem managed non-surgically

A

expel any clots manually

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

when is insertion of a catheter indicated in managing PPH

A

if uterine atony, to minimise the bladder pressure on the uterus

17
Q

what are the surgical methods of managing PPH

A 
balloon insertion to put pressure on the bleeding vessels 
arterial embolisation 
uterine artery ligation 
iliac artery ligation 
hysterectomy last resort
18
Q

when are perineal tears most common

A

in nulliparous women

19
Q

describe a first degree tear

A

involves vaginal skin and mucosa

20
Q

describe a second degree tear

A

involves the perineal muscles

21
Q

describe a 3a tear

A

involves <50% of external anal sphincter

22
Q

describe a 3b tear

A

involves >50% of external anal sphincter

23
Q

describe a 3c tear

A

involvement of internal anal sphincter

24
Q

describe a fourth degree tear

A

rectal mucosa torn

25
Q

how are perineal tears managed

A

local anaesthetic injected to branches of pudendal nerve and area is stitched at the time

26
Q

what is cord prolapse

A

descent of the umbilical cord through the cervix below the presenting part following rupture of membranes

27
Q

what are the main complications of cord prolapse

A

foetal asphyxia

28
Q

how does cord prolapse present

A

may be visible on examination

CTG changes - foetal bradycardia and variable decelerations

29
Q

how is cord prolapse managed

A

knee to chest position to relieve pressure
displace presenting part by inserting hand into vagina and pushing back up on contractions
give tocolytics

30
Q

what tocolytics are given and what is their effect

A

terbutaline - aim to reduce contractions

31
Q

what is the only definitive management of cord prolapse

A

delivery - either LSCS or assisted vaginal delivery if fully dilated

32
Q

what is shoulder dystocia

A

bony impaction of foetal anterior shoulder on maternal symphysis

33
Q

outline the risk factors for shoulder dystocia

A

obesity
macrosomia
prolonged labour
instrumental delivery

34
Q

what are the complications of shoulder dystocia

A 
asphyxia
hypoxic brain injury
brachial plexus injury
PPH
3rd and 4th degree tears
35
Q

what is the mnemonic for management of shoulder dystocia

A 
HELP 
H - help
E - evaluate for episiotomy 
L - legs into McRoberts manoeuvre
P - pressure suprapubically
36
Q

what is McRoberts manoeuvre

A

hyper flexed lithotomy position

37
Q

what is a useful position for a mother to get into if presenting with shoulder dystocia

A

roll onto all 4s

Reproduction and Sexual Health (22 decks)

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