delivery Flashcards
(25 cards)
(For partograms) How often are you checking fetal heart rate?
Every 5 mins
How often are you checking maternal pulse, BP, temperature?
Every 30 mins
Every hour for T
Urinalysis?
Every hour
How often do you do a PV exam?
Every 4 hours
At which point do you start a partogram?
3 cm dilatation
signs of first stage labour?
Show= bloody mucous
painful contractions
ROM
what is normal for fluctuations in fetal HR?
10-15
When should you encourage pushing, until when you discourage it?
until fully dilated
How should a woman push?
2-3 times after every contraction
What position should she be in?
LLP or kneeling
What are you doing once the head is born?
Give ergometrine/oxytocin to ppte stage 3
After anterior shoulder out?
Pull fetus anteriorly over pubic symphysis
How would you clamp the cord?
Clamp twice, cut 1-3 mins after delviery
What should you immediately do wrt baby??
Aspirate mucous General check Vitamin K APGAR score label keep warm give baby to mum- start suckling immediately
What do you do if there’s a cord prolapse?
Mother should be on all fours, and readied for a c-section
Apply gentle pressure to presenting part
Consider tocylytics such as terbutaline
If it’s extruded from the introitus keep warm
What do you do in shoulder dystocia?
McRoberts: Lie on back, hips hyperflexed Suprapubic pressure to rotate shoulders Via the vagina, place your hands on the back of the baby's shoulders to rotate them Grasp the posterior arm and pull
Or try the gaskin manouvre- on knees, arch back to open pelvic outlet
c/s?
How do you deal with secondary uterine inertia?
oxytocin or instrumental
OP?
maybe delivery
forceps/ c/s?
Narrow mid-pelvis?
instrumental, c/s?
PPH? Rx?
A, B, C Fluids IV Oxytocin, gentle suprapubic massage X-match Catheterise
the head is on the peritoneum, lift out delivery
Wrigley’s- short forceps
higher deliveries
neville-barneys- long forceps
suitable for rotation
Kiellands forceps
goes over the posterior fontanelle, head not higher than ischial spines
Ventousse (vacuum)
