Labour & Delivery Flashcards by Islean kinghorn

Classification in operative delivery

Outlet is

Fetal scalp visible without parting labia

Skull on pelvic floor

OA or OP or less than 45 degree to right or left

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Classification in operative delivery

Low is

Station +2 or more, not on pelvic floor

OA OP or OT

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Classification in operative delivery

Mid is

No more than 1/5 palpable per abdomen

Station 0 to +1

OA OP or OT

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By how long should labour ideally be postponed to post MI

2-3 weeks

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In cases of MOH what should the fibrinogen level be maintained above

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By how much is the risk of intracranial haemorrhage increased by with sequential instrumental delivery

2-3x

1:256

Compared to

1: 860 for vacuum
1: 664 for forceps
1: 954 for emcs

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What % of neonatal infection developing within 48hr of birth in the U.K. Is due to GBS

50%

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What % of symptomatic uterine ruptures are associated with perinatal mortality

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What is the incidence of cord prolapse in breech presentation

0.1-0.6% of all births

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What is the increased risk of perinatal mortality when cord prolapse occurs in the community

10x

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In otherwise uncomplicated preterm labour, by how much does tocolysis delay delivery by

7 days

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Regarding sickle cell disease during labour

What should be done if stars fall <94%

ABG and give O2

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What proportion of intrapartum CTG with reduced variability and late decelerations result in moderate to severe cerebral palsy

0.2%

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Which outcomes has STAN monitoring been shown to reduce

Operative vaginal delivery

FBS

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By how much does prophylactic oxytocin reduce the risk of PPH

60%

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Regarding untreated chlamydia infection at the time of delivery

What % of women will develop puerperal infection

34%

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Regarding untreated chlamydia infection at the time of delivery

What % of neonates will develop ophthalmia neonatorum

50%

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Regarding chlamydia infection at the time of delivery

What % of neonates will develop chlamydia pneumonitis

15%

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Regarding chlamydia infection in pregnancy

When after treatment should a test of cure be completed

5-6 weeks

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Regarding epidural

What is the risk of death

1: 140,000

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Regarding epidural

What is the risk of permanent nerve damage

1:13,000

Regarding epidural

What is the risk of significant hypotension

1:50

What is the effect of oxytocin on duration of labour

Shorten 1st stage by 1.3 hours

No effect on mode of delivery

What are the benefits of upright position in labour

Shortens 1st stage labour by 1.3 hours
Reduces need for epidural
Reduced 2nd stage
Reduces operative vaginal delivery

What are the benefits of hypnobirthing

Reduced pain Less epidural Shorter 2st stage

What is the half life of entonox

2-3 min

How long does pethidine stay in the neonate for

6 days

What is the risk of temporary nerve damage following epidural

1:1000

What is the failure rate for epidural

1/10

How long does an epidural take to set up and how long it till it is effective

20 min to set up | 20min till it's effective

Within what time frame should an epidural be sited after patient request

Within 30 minutes or a second anaesthetist should be called

Regarding first labours What is the average length How many hours are they unlikely to go beyond

Average 8 hours, unlikely to go beyond 18 hours

Regarding multip labours What is the average length How many hours are they unlikely to go beyond

Average 5 hours, unlikely to go beyond 12 hours

By how long does ARM shorten the duration of labour?

1hr

How soon after suspected delay in the 1st stage of labour should a VE be performed What progress is acceptable

After 2 hours Diagnose delay if progress is less than 1cm

By how much does active management of the third stage reduce the risk of pph >1L

50%

By how much does physiological vs active management of the third stage increase the risk of needing a blood transfusion

What diameter is seen in a Face presentation How many cm

Submento-bregmatic 9.5cm

What diameter is seen in a Brow presentation How many cm

Mento-vertical 13cm

What diameter is seen in a OP presentation How many cm

``` Suboccipito-frontal partially flexed 10.5cm Or Occipital-frontal d Deflected 11.5cm ```

What diameter is seen in a Well flexed OA How many cm

Subocipito-bregmatic 9.5cm

What diameter is seen in a Partially flexed OA How many cm

Subbocipital-frontal 10.5cm

What is the risk of neonatal infection if mother has 1st HVS infection within 6 weeks of delivery

41%

By how much do intarapartum Abx reduce the risk of neonatal GBS sepsis

80%

Overall incidence of 3/4 degree tear

2.9%

incidence of 3/4 degree tear in Primips

6.1%

incidence of 3/4 degree tear in multips

1.7%

Incidence of shoulder dystocia

0.5%

Regard shoulder dystocia What is the risk of brachial plexus injury Of which hoe many are permenant

2-16% 10% permanent

Regard shoulder dystocia By how much is the risk increased in DM

2-4x

Regard shoulder dystocia What is the risk of recurrence

1-25% 10x that of background population