Abnormal Labour Flashcards Preview

Reproduction > Abnormal Labour > Flashcards

Flashcards in Abnormal Labour Deck (27)
1

What is the most common reason for poor progression in an otherwise normal labour

Inefficient uterine contraction

2

What is the treatment of poor contractions

Rehydration
ARM
syntocinon

3

When does labour become abnormal

When there is a lack of progression
When there is fetal compromise
Malpresentation
Preterm labour
Uterine scar
Induced labour
Requires intervention
Require anaestetic input

4

Where is the tens machine targeted

T10-L1
S2-S4

5

How is diamorphine administered

IM

6

How is remifentanil administered

IV

7

What are the possible complications of an epidural

Can slow progress of the second stage of labour
Hypotension
Dural puncture (1 percent)
Headache
Back pain
Atonic bladder (40 percent)

8

When would you suspect failure to progress in the first stage if labour

Nulliparous - less than 2cm dilation in 4 hours
Parous - less than 2cm dilation in 4 hours or slowing progress

9

What are the 3 factors that cna cause poor progression of labour

Power - poor or infrequent contractions
Passages - shape, trauma
Passenger - big baby, malposition, cephalopelvic disproportion

10

What positions should the babies head be in

flexed

11

What results when the babies head is extended

Brow or face presentation

12

What are the risk factors for fetal hypoxia

Small baby
Preterm /post dates
Antepartum haemorrhage
Pre eclampsia
Diabetes
Meconium
Epidural analgesia
VBAC
PROM
Sepsis
Induction

13

What is a mornal baseline heart rate for a baby in labour

110-150bpm

14

What is normal baseline variability

5-25 bpm

15

What is a salutatory pattern

baseline variability more t than 25

16

When assessing the CTG what four areas should be noted

Baseline fetal heart rate
baseline variability
Presence or absence of decelerations
Presence of accelerations

17

What are normal decelerations

If there are none or if they are early ie at the peak of contraction

18

What are abnormal decelerations

Variable (occurring with over 50 percent of contractions) or late decelerations

19

What is the mnemonic for CTG interpretation

Determine
Risk
Contractions
Baseline
R
Ate
Variability
Accelerations
Decelerations
Overall

20

What is the only true way to find out if the fetus is distressed

fetal blood sampling

21

How can fetal distress be managed

Change in maternal position
Fluids
Stop syntocinon
Scalp stimulation
Consider tocolysis- Terbutaline
Operative delivery

22

How is fetal blood sampling interpreted

pH more than 7.25 = normal
7.2-7.25 = borderline, repeat in 30 min
less than 7.2 = abnormal = deliver

23

What are the indications for an operative delivery

Standard = delay, fetal distress
Special = maternal cardiac disease, severe PET, eclampsia, intra partum haemorrhage, umbilical cord prolapse stage 2

24

What is associated with the use of a ventouse cup

cephalohaematoma
retinal haemorrhage
failure

25

what are the positives of a ventous

less anaesthesia
vaginal trauma and perineal pain is reduced

26

What are the main indications for a caesarian

Previoud CS
Fetal distress
failure to progress in labour
breech
maternal request

27

What are the downsides to c section

4 x increase inmaternal mortality
due to sepsis, haemorrhage, VTE, subfertility, trauma, TTN, complications in future pregnancy