Extras

Question 1

How do you measure the foetal heart rate in intermittent auscultation?

Answer 1

Pinard stethoscope

hand held Doppler

Question 2

Name three methods of continuous foetal monitoring?

Answer 2

CTG
scalp ECG
abdo ECG

Question 3

What does ‘Dr C Bravado’ stand for in a CTG?

Answer 3

Dr - define risk
C - contractions

Bra - baseline rate
V - variability
A - acceleration
D - deceleration

O - overall

… normal … non-reassuring …. pathological

Question 4

What is a normal baseline foetal heart rate on a CTG?

Answer 4

110-160bpm

Question 5

What is normal amount of variability in foetal heart rate?

Answer 5

> 5bpm

Question 6

When is there sometimes less variability in foetal heart rate?

Answer 6

when they’re asleep!

but this shouldnt last more than 90mins

Question 7

Should acceleration be present on CTG?

Answer 7

yes

Question 8

Should deceleration be present on CTG?

Answer 8

early decels are normal
varibale decels are non-reassuring
late decels are pathological

Question 9

What do you worry about if there’s late decels on CTG?

Answer 9

placental insufficiency

Question 10

Which is more invasive but more effectives - scalp ECG or abdo ECG?

Answer 10

scalp ECG more invasive but more effective - don’t have to go through layers of abdo

Question 11

What else does CTG show except from foetal heart rate?

Answer 11

uterine contractions

Question 12

When does the first stage of labour end?

Answer 12

when cervix is fully effaced and dilated

Question 13

When does second stage of labour end?

Answer 13

with birth of babby!

Question 14

When does third stage of labour end?

Answer 14

with delivery of placenta

Question 15

What are three parts of the first stage of labour?

Answer 15

1. latent
2. active
3. transition

Question 16

A woman is having irregular contractions, lasting around 30 seconds each, with mucoid show. She is 2cm dilated. What stage in she in?

Answer 16

first stage - latent (0-3cm)

Question 17

A woman is having regular contractions, lasting 1 min each, 5cm dilated. What stage is she in?

Answer 17

first stage - active (3-7cm)

Question 18

A woman is having INTENSE contractions, lasting 2 mins and running into each other. She is screaming “I’m gonna die”. Her waters have broken and she is 9cm dilated. What stage is she in?

Answer 18

first stage - transition (7-10cm)

Question 19

Which stage of labour is the pushing stage, when the head comes through the pelvis?

Answer 19

second stage

Question 20

Which foetal lie is ideal?

Answer 20

longitudinal

Question 21

What is foetal station?

Answer 21

presenting part in relation to ischial spines. (a.k.a degree of descent)

Question 22

What is foetal engagement?

Answer 22

head in pelvis (5/5 engaged = head fully in)

Question 23

When should you “now pant, Maureen. Pant”

Answer 23

crowning (so don’t tear)

Question 24

What position should baby be in when coming out?

Answer 24

face down
(occipito-anterior)

Question 25

What is waters breaking?

Answer 25

amniotic sac rupturing

Question 26

Describe what happens in the third stage of labour.

Answer 26

uterus contracts placenta separates from wall placenta delivered

Question 27

When is the window of implantation?

Answer 27

day 20-24

Question 28

In what situation does Rhesus disease happen?

Answer 28

Rhesus neg sensitized mum attacks Rhesus pos baby

Question 29

In rhesus disease, rhesus neg sensitized mum attacks Rhesus pos baby. What does this cause for the foetus?

Answer 29

haemolysis - anaemia

Question 30

Who do you give anti-D prophylaxis to?

Answer 30

all rhesus negative pregnant women

Question 31

Name non pharma management of labour pain

Answer 31

hydrotherapy massage TENS (transcutaneous electrical nerve stimulation)

Question 32

Analgesia in labour can be systemic or regional. Name two systemic and two regional.

Answer 32

systemic: IM pethidine Entonox regional: epidural spinal

Question 33

where does spinal cord end?

Answer 33

L1/2

Question 34

Where do you go in for epidural?

Answer 34

L3/4 (btw iliac crests)

Question 35

What are two problems with epidural?

Answer 35

best pain relief but may prolong labour and raise mother's temp.

Question 36

How is spinal different to epidural?

Answer 36

go THROUGH dura into CSF to make completely numb fast (intra-thecal)

Question 37

When do you use spinal anaesthetic?

Answer 37

only for defined period e.g. before elective Caesarean (cant leave cath in, dont want CSF infection)

Question 38

With general anaesthetic - what is one danger to mother and one danger to baby?

Answer 38

mother - aspiration gastric contents | baby - risk of anaesthetising baby

Question 39

Give me some examples of when sensitization culd happen (foetal and mum's blood mixing)?

Answer 39

abdo trauma APH amniocentesis / invasive procedures

Question 40

When is booking appointment?

Answer 40

8-12wks

Question 41

When is dating scan? What else happens at dating scan as well as dating?

Answer 41

12 wks | screening for trisomy 13 (patau's), 18, 21.

Question 42

When is first trimester?

Answer 42

conception - 12wks

Question 43

When is second trimester?

Answer 43

13wks - 27wks

Question 44

When is third trimester?

Answer 44

28wks - 41wks

Question 45

How long does each trimester roughly last?

Answer 45

3 months

Question 46

When is the anomaly scan?

Answer 46

20wks

Question 47

Midwifery check, birth planning and education appointment. When is this?

Answer 47

34wks