Childbirth

Question 1

in stage 1, how often should a doppler of the fetal heart be done?

Answer 1

every 15 mins

Question 2

in stage 2, how often should a doppler of the fetal heart be done?

Answer 2

every 5 mins

Question 3

what are the stages of labour? what happens?

Answer 3

1 - dilation of cervix
2 - expulsion of fetus
3 - expulsion of placenta and fetal membranes

Question 4

in a nulliparous and multparous women, what is poor progress in labour classified as?

Answer 4

nilliparous - <2cm in 4 hrs

multiparous - <2cm in 4hrs or slowing progress

Question 5

what are 3 causes of poor progress in labour? what measures this?

Answer 5

power
passage
passenger
PARTOGRAM

Question 6

2 common side effect of diamorphine injection?

Answer 6

itchy nose

respiratory depression

Question 7

what to give to baby if it is effected by morphine? what would it be suffering from?

Answer 7

naloxone

respiratory depression

Question 8

where does an epidural block pain fibres from?

Answer 8

T10-S5

Question 9

nerve supply of uterus and birth canal?

Answer 9

utertus T10-12

birth canal S2, 3, 4

Question 10

what is primary PPH?

Answer 10

loss of >500mls in first 24hrs after delivery

Question 11

what is secondary PPH?

Answer 11

excessive blood loss 24hrs after delivery

Question 12

what increases risk of PPH?

Answer 12

prolonged labour
active management of stage 3 pregnancy
Hx of problems

Question 13

Tx for PPH?

Answer 13

uterine massage
syntocinon
carboprost

Question 14

what can be done during active management of the third stage of pregnancy?

Answer 14

syntometerine
oxytocin
controlled cord traction
cord clamping and cutting

Question 15

signs of placental separation after delivery?

Answer 15

umbilical cord lengthens
blood loss
uterus contracts and hardens

Question 16

during birth, what does zero fifths palpable mean?

Answer 16

head cannot be felt in abdo, is fully engaged

Question 17

during birth, what does five fifths palpable mean?

Answer 17

head can be fully felt in abdo

Question 18

what scoring system can be used for inducing?

Answer 18

bishops

Question 19

what is the order of mechanisms of labour?

Answer 19

descent
flexion
IR
crowning
extension
restitution 
lateral flexion

Question 20

what happens during descent?

Answer 20

fetus descends into pelvis due to force of contractions

Question 21

what happens during flexion?

Answer 21

chin touches chest and arms cross

Question 22

what happens during IR?

Answer 22

head rotates forward 45 degrees as it reaches birth canal

Question 23

what happens during crowning?

Answer 23

head escapes under pubic arch

Question 24

what happens during extension?

Answer 24

head extends so it can pass over perineum

Question 25

what happens during restitution?

Answer 25

shoulders rotate to AP plane

head then restitutes by coming into line with shoulder

Question 26

what happens during lateral flexion?

Answer 26

anterior shoulder born first via downward traction

lateral flexion so posterior shoulder is delivered

Question 27

surgical Tx for PPH?

Answer 27

balloon

uterine artery ligation hysterectomy

Question 28

what bishops score suggests that pregnancy will not require induction?

Answer 28

> 6

Question 29

when is induction done?

Answer 29

> 12 days after due date

prelabour premature membrane rupture where labour doesn’t start

Question 30

if a delay in first stage of labour, what are Tx options?

Answer 30

artificial membrane rupture

if already done, oxytocin infusion

Question 31

if a delay in second stage of labour, what are Tx options? how long is a delay?

Answer 31

instrumental delivery
cesarean

≥ 1hr

Question 32

who are oxytocin infusions dangerous in?

Answer 32

Hx of cesarean

Question 33

what type of operative vaginal delivery poses more risk to the child? what is safer for mum?

Answer 33

ventouse > forceps for mum

forceps > ventouse for child

Question 34

normal fetal HR?

Answer 34

100-160bpm

Question 35

worrying features of CTG?

Answer 35

brady/tachycardia
reduced variability
decelerations

Question 36

if a baby is premature, when is this and what should be given?

Answer 36

<37 wks

betamethasone

Question 37

if post term, what is done? when is this?

Answer 37

41 weeks
membrane sweep
vaginal prostaglandin
oxytocin