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ADELE-Repro Ramblings > Child birth > Flashcards

Child birth Flashcards

1
Q

Preterm is birth before how many weeks?

A

37 weeks

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2
Q

Term is birth at what week gestation?

A

37-42 weeks

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3
Q

Post term is how many weeks gestation?

A

42wks–>

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4
Q

What is the lie?

A

The relation of the longitudinal axis of the focus to the longitudinal axis of the uterus

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5
Q

TRUE/FALSE

The foetus is engaged if the widest leading part has passed through the pelvic inlet

A

TRUE

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6
Q

What is labour?

A

The Physiological process during which the foetus, membranes, umbilical core and placenta are expelled from the uterus

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7
Q

Labour is associated with regular, painful contractions with increasing frequency and intensity TRUE/FALSE

A

TRUE so true

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8
Q

uterus excitability is due to

A

Oestogen and oxytocin

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9
Q

Myometrial stretch increases the —- of myometrial fibres

A

Excitability

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10
Q

Mechanical stretch of cervix and stripping of the fetal membranes causes further —— release

A

Oxytocin

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11
Q

What is Fergusons reflex?

A

Self-sustaining cycle of uterine contractions initiated by pressure at the cervix or vaginal walls- positive feedback

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12
Q

Which hormone initiates and sustains contractions?

A

Oxytocin

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13
Q

What is the purpose of the liquor?

A

nourishes and protects fetus and facilitates movement

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14
Q

If meconium is thick and heavy what is the baby at risk of?

A

Aspiration

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15
Q

What is the cervical tissue made of?

A

Collagen tissue (types 1-4)
Smooth muscle
Elastin
Held together by connective tissue

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16
Q

Cervical softening is caused by what?

A

An increase in hyaluronic acid

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17
Q

What does Bishops score determine?

A

If it is safe to induce labour

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18
Q

What bishops score indicates that she is ready for labour?

A

> 8

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19
Q

What is the first stage of labour divided up into?

A

Latent stage

Active stage

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20
Q

Describe the latent stage of labour?

A

up to 3-4cm dilated
mild irregular uterine contractions
Cervix softens and shortens
duration variable-may last a few days

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21
Q

What are the stages of labour?

A

First- Divided into latent and active stage
Second
Third

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22
Q

Describe the active stage of labour

A

4cm-10cm (full dilation)
slow descent of presenting part
contractions more rhythmical and stronger

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23
Q

What is the normal rate of progression for the active stage of labour?

A

1-2cm per hour

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24
Q

What happens in the second stage?- from when to when

A

Full dilation –> Delivery of the baby

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25
Q

When is the second stage considered prolonged?

A

No babies- 3h+ with analgesia (2+ without)

If babies- 2h+ with analgesia (1+ without)

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26
Q

What is the third stage of labour?

A

Delivery of baby–> Expulsion of the placenta and membranes

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27
Q

How long should the third stage take?

A

3-30m (average 10m)

28
Q

What is the active management of the third stage?

A

Oxytocic drugs - syndometerine 1ml or Oxytocin 10 units

Controlled cord traction

29
Q

Name the 3 signs of separation

A

1- Uterus contrast, hardens and rises
2-Umbilical cord lengthens permanently
3-Gush of blood (not always, variable in amount)

30
Q

What is the plan of separation?

A

Spongy layer of the decider basalis

31
Q

What is the normal level of blood loss?

A

<500mls

32
Q

Haemostasis is achieved by which 3 things:

A

1-Tonic contraction
2-Thrombosis of the torn vessel ends
3-Myo-tamponade

33
Q

When are Braxton hicks commonly?

A

can start 6wks into pregnancy, usually in 3rd trimester

34
Q

What differentiates Braxton hicks contractors from labour contractions?

A

They are irregular and do not increase in frequency or intensity

35
Q

What is the name of the contractions tightening the top of the uterus pushing the baby downward into the birth canal in preparation?

A

Fundal dominance

36
Q

What is the most suitable type of pelvis?

A

Gynaecoid

37
Q

What is the pelvis type that most African-carribean women have?

A

Android

38
Q

What are the 5 parameters of cervical assessment:

A 
Effacement
Dialtion
Firmness
Position
Station
39
Q

What is the best analgesic to use?

A

Entonox

but makes some women feel sick, strange euphoric feeling

40
Q

What is the transverse diameter at the pelvic inlet?

A

13cm

41
Q

What is the AP diameter at the pelvic outlet?

A

13cm

42
Q

What are the 7 cardinal movements of labour

A
  1. Engagement
  2. Descent
  3. Flexion
  4. Internal Rotation
  5. Crowning and extension
  6. Restitution and external rotation
  7. Expulsion
43
Q

When the largest diameter of fatal head is enriched by the vulval ring what will the mother feel?

A

Burning and stinging feeling

44
Q

Benefit of delayed cord clamping

A

Higher RBC flow to vital organs in 1st week

Less anaemia at 2months

45
Q

What are the benefits of skin to skin contact

A

Bonding

Breast feeding rates increase

46
Q

How long is it to the return of tissues to a non-pregnant state?

A

~6 weeks

47
Q

How long does it take post pregnancy for the endometrium to regenerate?

A

End of a week

except the placental site

48
Q

What is the length of a good contraction/

A

30s

49
Q

What are the 3 types of breech presentation?

A

Complete breech
Footling breach
Frank breach

50
Q

What is the aetiology of labour pain?

A

Compression or para-cervical nerves/myometrial hypoxia

51
Q

What is the drug used in epidural?

A

Levobupivacaine +- Opiate

52
Q

What does a partogram measure?

A 
Fetal heart
amniotic fluid
cervical dilation
descent
contractions
obstruction-moulding
maternal observations
53
Q

What drug can be given if there is failure to progress?

A

Synthetic oxytocin

54
Q

What are 3 ways of intra-partum petal assessment?

A

Doppler auscultation of fetal heart
Electronic fetal monitoring- Cardiotocograph (CTG)
Colour of amniotic fluid

55
Q

What is vasa previa?

A

A condition where the fatal blood vessels cross or run near the internal opening of the uterus

56
Q

What pH on fatal sampling would indicate that the baby needed to be delivered?

A

<7.20

57
Q

Decelerations are reassuring TRUE/FALSE

A

FALSE

58
Q

What fatal HR is counted as tachycardia?

A

> 150

59
Q

What are the causes of a collapses obstetric patient?

A

4Hs and the 4Ts

Hypoxia, Hypovolaemia, Hyperkalaemia/Hypokalaemia, Hypothermia

Tablets/toxins, tamponade, tension pneumothorax, thrombosis

60
Q

The uterus compressing IVC and aorta leads to …. …..

A

Supine hypotension

61
Q

How is aortocaval compression reversed?

A

Turning the lady onto her left lateral position

62
Q

In chest compression in non pregnant women it achieves around 30% of normal CO, in pregnant women how much is this reduced?

A

Further reduced CO by around 10%

63
Q

Define Small for gestational age

A

Estimates fatal weight or abdominal circumference below the 10th centile

64
Q

What is polydramnios?

A

Excess amniotic fluid (AFI >25)

65
Q

Management of diabetes in pregnancy?

A

Aim for 48mmol/mol
stop embryopathic medication e.g. ACEi
5mg folic acid and aspirin pre conception

66
Q

At what HbA1c would you advise them to not get pregnant?

A

86mmol or more

67
Q

When can the USS confirm that it is indeed a multiple pregnancy?

A

12wks

ADELE-Repro Ramblings (21 decks)

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