Flashcards in Complications in Delivery Deck (78)
A baby is born prematurely if it is delivered before what gestation?
What is the usual gestation and birthweight of viability of a foetus?
24 weeks, > 500g
What is the strongest risk factor for preterm delivery?
Previous preterm delivery
What is the main complication of PPROM for the mother?
Pooling of amniotic fluid in the posterior vaginal vault on speculum examination is suggestive of what diagnosis?
Should you perform a digital vaginal examination in a woman with PPROM?
What may an ultrasound scan of a woman with PPROM show?
How is PPROM managed medically?
10 day course of erythromycin and also give corticosteroids
At what gestation should delivery be considered in women with PPROM?
To assess the likelihood of preterm delivery in women who are deemed to be high risk, ultrasound is used to measure what?
Women with a cervical length of less than what are at higher risk of preterm birth?
What procedure can be used in women who have a high-risk of premature delivery to reduce the risk of this occurring?
Cervical suture (cerclage)
If an abdominal suture is inserted in a woman who is very high risk of premature delivery, how must the baby then be delivered?
If a woman presents with painful contractions and backache suggestive of premature labour, combined with PV bleeding, what is likely the event that triggered the labour?
If a woman presents with painful contractions and backache suggestive of premature labour, combined with loss of fluid vaginally, what is likely the event that triggered the labour?
Premature labour can be diagnosed by examination alone once what is seen?
Cervical dilation > 3cm
The fibronectin or Actim Partus tests can be used to assess the likelihood of what complication?
In cases of suspected preterm labour, what investigations should be carried out to screen for infection?
Urine sample and vaginal swabs
After PPROM, what investigations are carried out to monitor for infection?
FBC and CRP
What is the aim of management of preterm labour?
To delay delivery to allow administration of corticosteroids and transfer to hospital
Via what route are corticosteroids given to women in preterm labour?
The beneficial effects of maternal corticosteroids are apparent if the baby is born how long after the second dose? How long do the effects of the steroids last for?
24 hours / 7 days
What medications can be used in women in preterm labour to inhibit contractions and delay delivery?
What is the commonest malpresentation at labour?
For which malpresentations of the foetus is a vaginal delivery possible?
Breech and face presentations
For which malpresentations of the foetus is a vaginal delivery not possible?
Shoulder and brow presentations
If malpresentation of the foetus is suspected clinically, this can be confirmed with which investigation?
What is the first line management option for malpresentation of the foetus?
External cephalic version
Is perinatal morbidity and mortality higher with a vaginal breech delivery or a C-section?
Vaginal breech delivery