Intrapartum Care Flashcards Preview

Jason's MD3 Women's > Intrapartum Care > Flashcards

Flashcards in Intrapartum Care Deck (23):
1

Labour definition?

Painful contractions in association with:

Cervical dilation
Ruptured membranes
Show (bleeding

2

INvestigation when first start labour?

admission CTG

3

6 steps intrapartum care

X mother
Fetal surveillance
Ax of progress
Foods and fluids?
AbX?
Pain relief?

4

Reasons for Abx? 4 weeks

GBS
Prolonged ruptures membranes: more than 18hours
suspected chorioamnionitis (fever)
Endocarditis prophylaxis

5

How often vaginal exam during labout?

Every 4 hourly

6

GBS

20% of women
1 in 200 carriers serious fetal infection
1 in 5 fetal infection death or permanent disability

7

GBS if penicillin sensitive?

Clindamycin
erythromycin
Need sensitivities?

8

3 pharma pain relief

Nitrous (edge only)
Narcotics
Regional

9

Parental narcotics?

Heroin (not in Australia)

10

Narcotics S/Fx

N&V
Stematil, Maxalon
Resp. Depression
Constipation

11

Narcotic dosage?

morphine: 10mg 3-4 hourly
Pethiein: 100mg 3-4hourly
Fentanyl: IV infusion

12

How to treat respiratory depression in preg?

Naloxone for mother
Not for baby: stim cause don't want it to wear off before morphine is still on born

13

Why is narcotics doesn't work for labour? (Or renal colic)

Intermittency: can't give enough during peak

14

Fast way to get drugs in and out?

Inhalation
Fat-soluble

15

REgional anaesthesia?

Epidural - large volume: catheter
Spinal: subarachnoid space: no catheter
Combined

16

Contraindication to regional analgesia

Absolute: allergy: infection

Relative:
Coagulopathy
Systemic sepsis

17

regional analgesia which drugs?

Xylophone
Bupivicaine, rope acting
Fentanyl
Adrenalit

18

Side effect of regional analgesia? Immediate?

Hypotension - COxTPR due to reflex sympathetic vasodilation of arterioles and venues
Rx: fluids or sympathomimetic

19

Which vessels are innervated By sympathetic return?

Arterioles and venules (reservoir)

20

Why not use colloids more in preg?

Anaphylaxis!
Use crystalloid

21

Adrenaline which receptors?

Adrenaline: Beta
Noradrenaline: Alpha

22

Adrenaline comes in what?

1ml: 1:1000 adrenaline

23

Rural puncture headache?

LowerS CSF pressure, pulls on meninges

Lie flat
Blood patch