Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproduction and Sexual Health > Abnormal Labour and Obstetric Emergencies > Flashcards

Abnormal Labour and Obstetric Emergencies Flashcards

(65 cards)

Start Studying
1
Q

List different reasons why a labour may be classified as ‘abnormal’.

A
  • Malpresentation – non vertex
  • Malposition – OP or OT
  • Preterm <37 weeks
  • Post-term >42 weeks
  • Obstruction
  • Foetal distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the boundaries of the vertex.

A

Anterior and posterior fontanelles and the parietal eminences

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

After how many weeks of pregnancy do the rates of stillbirth increase a lot?

A

After 37 weeks

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

What type of delivery is necessary if there is a cord prolapse?

A

C - section (think C for Cord

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

What baby position usually requires a c section?

A

BREECH

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

Describe complete breech position.

A

Legs crossed with babies feet and its bottom

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

Describe the footling breech position.

A

One or both feet point down so that the legs will come out first

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

Describe the frank breech position.

A

Legs are lifted up and touching the babies head so that the bottom comes out first

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

What does malpresentation mean simply?

A

When the baby is in any position that is not vertex

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

List the 4 main types of breech position.

A
  • Transverse
  • Shoulder-arm
  • Face (MA or MP)
  • Brow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is MA position? What kind of delivery is required?

A

Menoanterior (mento is chin)

This can deliver anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is MP position? What kind of delivery is required?

A

Menoposterior - the chin is posterior

This needs a c section

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

What type of situation can epidural not be given in?

A

Emergency

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

What type of analgesia must be given in an emergency?

A

GA or spinal

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

What is IV Remifentanil PCA?

A

A very short acting opiate that works quickly

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

What is Entonox also known as?

A

Gas and air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is epidural good?

A

Yes, it provides pain relief for 95% of people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Epidural does not impair _______ ________?

A

Uterine activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may epidural inhibit?

A

Processes during the second stage of labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 2 components of epidural?

A

Levobupivacaine +/- Opiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List the 5 main side effects of epidural.

A
  • Hypotension (20%)
  • Dural puncture (1%)
  • Headache
  • High block
  • Atonic bladder (40%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can dural puncture cause?

A

CSF leak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the main symptom of CSF leak?

A

AWFUL headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What 3 things should be looked at when assessing the progress of labour in stage 3?

A
  • Cervical dilatation
  • Descent of presenting part
  • Signs of obstruction e.g moulding, caput, anuria, haematuria, vulval oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Describe moulding.
When fontanelles merge over each other and cannot be reduced, this is a sign of obstruction
26
Describe caput.
The fontanelles feel swollen, also a sign of obstruction
27
What 2 things would indicate a delay of pregnancy? (describe in terms of nulliparound and porous women)
* Nulliparous - <2cm dilation in 4 hours | * Parous - <2cm dilation in 4 hours/slowing in progress
28
What are the 3 P's?
Power Passage Passenger
29
Describe powers.
CONTRACTIONS Inadequate contractions – frequency +/- strength
30
Describe passage.
MATERNAL PELVIS Short stature, trauma or shape
31
Describe passengers.
BABY * Big baby * Malposition – relative cephalon-pelvic disproportion
32
What is a partogram?
This is a graphic representation of the progress of labour
33
What 7 things does a partogram take a recording of?
* Foetal heart * Amniotic fluid * Cervical diltation * Dsecent * Contractions (frequency not intensity) * Obstruction * Maternal observations
34
What 3 things should an intra-partum foetal assessment involve?
* Doppler auscultation of fetal heart * Cartiotocograph (CTG) +/-STAN * Colour of amniotic fluid – normal is clear
35
During stage 1 of labour, how often is doppler auscultation of the foetal heart done?
* During and after a contraction | * Every 15 minutes
36
During stage 2 of labour, how often is doppler auscultation of the foetal heart done?
* At least every 5 minutes during and after a contraction for 1 minute ! * Check maternal pulse every 15 minutes too
37
Why is it important to do constant monitoring of the foetal heart?
There are lots of causes of foetal hypoxia
38
Outline ACUTE causes of foetal distress.
* Abruption * Vasa Praevia * Cord Prolapse * Uterine Rupture * Foeto-maternal haemorrhage * Uterine hyperstimulation * Regional anaesthesia
39
Outline CHRONIC causes of foetal distress.
* Placental insufficiency | * Foetal anaemia
40
Outline SUBACUTE causes of foetal distress.
Foetal hypoxia
41
Early decelerations are physiological
TRUE
42
Late decelerations are pathological
TRUE
43
What are early decelerations due to?
Due to vagal maneuver – they are completely benign
44
What are late decelerations a sign of?
HYPOXIA !!!
45
Variable decelerations can be normal OR a sign on ....
Cord compression !!
46
When assessing a CTG, there are 4 different categories which should be considered …
* Baseline foetal heart rate * Baseline variability * Presence or absence of decelerations * Presence of accelerations
47
CTG results are either – normal, suspicious or pathological. Outline what should be done for each.
* Normal – leave this baby * Suspicious – observe and make any changes * Pathological - deliver as you think the baby is at risk of hypoxia
48
What acronym is used in CTG analysis?
DR C BRAVADO
49
DR C BRAVADO ....
D – determine R – risk C – contractions ``` B – baseline RA – rate V – variability A – accelerations D – decelerations O – overall impressions ```
50
Outline the management of foetal distress.
* Change maternal position * IV Fluids * Stop syntocinon * Scalp stimulation * Consider tocolysis - Terbutaline 250 micrograms s/c * Maternal assessment – pulse, BP, abdo exam, vaginal exam * Foetal blood sampling * Operative delivery
51
Where is a foetal capillary sample taken from?
Babies scalp
52
How many cm dilated does the mother have to be to be able to insert a cone and take a capillary sample from the babies head?
4 cm
53
What pH required immediate delivery of the baby?
< 7.20
54
What pH requires a repeat test in 30 mins?
7.20-7.25
55
What is a ventrouse?
A vaccum extractor for use in assisting childbirth
56
In Tayside, forceps are more commonly used than suction cups
TRUE
57
List the 5 main indications for a c section.
* Previous c-section * Foetal distress * Failure to progress in labour * Breech * Maternal request
58
4x’s greater maternal mortality is associated with c-section
TRUE :(((((
59
Shoulder dystocia - head comes out but anterior shoulder gets stuck between symphysis pubis What is there a risk of? What do you therefore have to do?
Hypoxia Deliver the baby in 7 minutes !!!
60
4 H’s and 4 T’s - reversible causes + Pre-eclampsia and amniotic fluid emoblism What do all of the above cause?
Maternal collapse
61
What are the 4 H's that cause maternal collapse?
* Hypovolaemia * Hypoxia * Hyperkalemia or hypokalemia/ metabolic * Hypothermia
62
What are the 4 T's that cause maternal collapse?
* Tablets or toxins * Tamponade * Tension pneumothorax * Thrombosis
63
What is aortocaval compression?
From 20 weeks gestation, in the supine position the gravid uterus can compress IVC and aorta reducing venous return
64
What does aorticaval compression do to cardiac output?
Decreasing cardiac output by up to 40%, causing supine hypotension
65
What is perimortem c section?
A resuscitative hysterotomy, also referred to as a perimortem Caesarean section (PMCS) or perimortem Caesarean delivery (PMCD), is a hysterotomy performed to resuscitate a woman in middle to late pregnancy who has entered cardiac arresst

Reproduction and Sexual Health (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions