Abnormal Labour Flashcards Preview

3MB Reproduction > Abnormal Labour > Flashcards

Flashcards in Abnormal Labour Deck (20):
1

List factors that determine labour as abnormal

Too early
Too late
Too painful
Too long
Foetal distress
Intervention required (operative)

2

What causes transient hypoxia in a baby during labour?

Uterine contractions (interrupt placental blood supply)

3

List options for providing analgesia during labour

Support, massage/relaxation techniques
Paracetamol
Entonox (laughing gas)
TENS
Water immersion
IM diamorphine
IV remifentanil
Epidural anaesthesia

4

Epidural anaesthesia impairs uterine activity. True/False?

False
May inhibit progress during stage 2 labour, however

5

What vertebral level is the epidural anaesthetic injected into?

L3/L4 space

6

List potential complications of epidural anaesthesia

Hypotension
Dural puncture
Headache
Backache
Atonic bladder

7

What counts as delay in stage 1 labour?

Nulliparous woman: less than 2cm dilation in 4 hours
Parous woman: less than 2cm dilation in 4 hours OR slowing in progress

8

What are the 3 P's that affect progression of labour?

Power (inadequate contractions)
Passage (shape/state of pelvis)
Passenger (big baby, malposition)

9

Going down the pelvis, the transverse diameter increases/decreases and the anteroposterior diameter increases/decreases

Going down the pelvis, the transverse diameter decreases and the anteroposterior diameter increases

10

What is a partogram?

Graphical representation of the progression of labour

11

What is assessed on a partogram?

Foetal heart rate
Amniotic fluid
Cervical dilation
Descent
Contractions
Obstruction (moulding/caput)
Maternal vital signs

12

How often is the foetal heart auscultated during labour?

Stage 1: during + after a contraction/every 15 mins
Stage 2: every 5-10 mins

13

Meconium (foetal stool) can be a sign of what?

Foetal distress

14

What is a CTG used for?

Assess foetal heart

15

You can only assess frequency of contractions on a CTG, not strength. True/False?

True

16

What is a normal foetal heart rate?

110-165 bpm

17

What 4 features are assessed on a CTG?
What is the mnemonic for remembering this?

Heart rate, variability, accelerations, decelerations
Mnemonic:
Determine
Risk
Contractions
Baseline
R
Ate
Variability
Accelerations
Decelerations
Overall impression

18

Outline management of foetal distress in labour

Change maternal position
IV fluids
Stop syntocinon
Consider tocolysis
Foetal blood sampling (hypoxia)
Operative delivery

19

What is a normal pH to obtain upon foetal blood sampling?

pH greater than 7.25

20

What are the main indications for cesarean section?

Previous CS
Foetal distress
Failure to progress in labour
Breech presentation
Maternal request