Flashcards in Labour Deck (16):
At what rate should the cervix dilate in a primip?
1cm in 2 hours
What are the causes of delayed labour?
Power, passenger, passage
What are the normal movements of the baby through labour?
Engagement (in OT position)
Internal rotation (to OA position
Restitution / external rotation
Delivery of anterior shoulder
Delivery of posterior shoulder
Delivery of placenta
What things are assessed on a CTG?
Accelerations / decelerations
How often should a PV exam be performed?
Every 4 hours to assess for progression
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
What are options for management of stage 3?
Active: oxytocin ± traction ± manual removal
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
What is management of uterine rupture?
Call for help, ABCDE resus, emergency laparotomy
What is definition of primary PPH?
>500mL of blood within 24 hours of delivery
What are the different grades of PPH?
What factors affect PPH?
Tone, tissue, trauma and thrombin
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
What are the main causes of secondary PPH?
Infection and retained products
What are complications of C-section?
Bleeding, infection, slower recovery, damage to bladder, bowel, ureters.
Can consider VBAC if only one C-section.