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Flashcards in Labour Deck (16):
1

At what rate should the cervix dilate in a primip?

1cm in 2 hours

2

What are the causes of delayed labour?

Power, passenger, passage

3

What are the normal movements of the baby through labour?

Engagement (in OT position)
Descent
Flexion
Internal rotation (to OA position
Extension
Restitution / external rotation
Delivery of anterior shoulder
Delivery of posterior shoulder
Delivery of placenta

4

What things are assessed on a CTG?

Baseline HR
Variability
Accelerations / decelerations

5

How often should a PV exam be performed?

Every 4 hours to assess for progression

6

What are the stages of labour?

Stage 1 (latent): 0-4cm dilated
Stage 1 (active): 4-10cm dilated
Stage 2 (passive): 10cm until woman has urge to push
Stage 2(active): pushing
Stage 3: delivery of placenta

7

What are options for management of stage 3?

Expectant
Active: oxytocin ± traction ± manual removal

8

What is the presentation of uterine rupture?

1) Previous C-section - ruptures through scar
2) Acute onset of foetal distress (CTG changes)
3) Maternal tachycardia, pain, bleeding, shock

9

What is management of uterine rupture?

Call for help, ABCDE resus, emergency laparotomy

10

What is definition of primary PPH?

>500mL of blood within 24 hours of delivery

11

What are the different grades of PPH?

Minor: 500-1000mL
Major: 1000-1500mL
Massive: >1500mL

12

What factors affect PPH?

Tone, tissue, trauma and thrombin

13

What is the management of PPH?

Call for help, ABCDE resus

Tone: Bimaual compression, oxytocin, etc.
Trauma: explore genital tract for trauma
Tissue: Inspect placental completeness
Thrombin: FBC, clotting, replace factors

+ empty bladder + consider balloon tamponade

14

What are the main causes of secondary PPH?

Infection and retained products

15

What are complications of C-section?

Bleeding, infection, slower recovery, damage to bladder, bowel, ureters.

Can consider VBAC if only one C-section.

16

What are options for analgesia in labour?

None, gas and air, morphine, epidrual.