Maternity

Question 1

What timeframe is know as preterm

What timeframe is know as term

Answer 1

Preterm: 24 - 37 weeks gestation

Term: 37 - 42 weeks gestation

Question 2

What is the first stage of labour

Answer 2

Onset of regular painful contractions to full cervical dilatation (i.e contractions every 2 - 20 minutes, 20 - 60 seconds in duration).

Question 3

What is the Second stage of Labour

Answer 3

Full Cervical Dilatation to birth of baby.

typical duration primipara 1 - 2 hours, multipara 15 - 45 minutes

Question 4

What is some signs of Imminent birth.

Answer 4

• Active Pushing
• Grunting
• Anal Pouting
• Bulging or perineum
• Presenting part (crowning)
• ## Rectal Pressure (urge to use bowels or bladder)

Question 5

What is the Pathophysiology of Pre- Eclampsia/ Eclampisa

Answer 5

Pre-eclampsia refers to a set of symptoms rather than any causative factor, and there are many different causes for the condition. It appears likely that there are substances from the placenta that can cause endothelial dysfunction in the maternal blood vessels of susceptible women.
While blood pressure

elevation is the most visible sign of the disease, it involves generalized damage to the maternal endothelium, kidneys, and liver, with the release of vasoconstrictive factors being secondary to the original damage.

Question 6

What is the definition of a Misscarriage

Answer 6

he spontaneous loss of pregnancy before 20 weeks’ gestation, or < 400 grams birth weight if gestational age is unknown. In the majority of cases, the aetiology is unknown. Up to 1 in 4 known pregnancies will end in first trimester miscarriages, most commonl

Common Causes

• Chromosomal abnormalities or fetal anomalies;
• Drug and alcohol use;
• Maternal illness and infection;
• Autoimmune factors and thrombophilic defects;
• Obesity;
• Cervical incompetence.

Question 7

What is an Ectopic Pregnancy

Answer 7

An ectopic pregnancy occurs in approximately 1-2 % pregnancies and is caused by the developing embryo implanting outside the uterine cavity. 98% of ectopic pregnancies will occur within one of the fallopian tubes. This may be diagnosed, suspected or undiagnosed as the gestation of rupture is commonly as early as 6 – 8 weeks’ gestation, when the woman may not be aware she is pregnant.

Question 8

What is an Antepartum Haemorrhage

Answer 8

bleeding from the genital tract from 20 weeks gestation.

50% of APH cases are idiopathic, however other significant causal factors include:

• Placental abruption;
• Placenta praevia;
• Trauma (including domestic violence);
• Uterine rupture.

Question 9

What is a Placental Abruption

Answer 9

Approximately 30% of incidences of APH are the result of placental abruption. This is premature partial or total separation of a normally implanted placenta after the 20th week of pregnancy. This occurs when a haematoma forms between the placenta and the uterine wall which results in the placenta separating from the maternal vascular bed. This occurs in 1 – 2% of all pregnancies, with fetal loss in 35% of cases due to hypoxia.

Question 10

What is Placenta Previa

Answer 10

Approximately 20% of all APH cases are caused by placenta praevia, when the placenta is abnormally situated in the lower segment of the uterus, either completely or partially covering the internal cervical os.

Question 11

Uterine Rupture

Answer 11

Uterine rupture may be complete, that is, through the full thickness of uterine wall; or incomplete, where the serosa remains intact. It may occur spontaneously or through reopening of a previous C-section scar (most common), obstructive labour or traumatic rupture including direct trauma.

Question 12

What is Preterm Labour

Answer 12

Preterm labour refers to uterine contractions present @20-37 weeks gestation.
At this early stage there is a high possibility of abnormal presentation – 30% of babies delivered <37weeks are born breech. This is due to fetal rotation into the cephalic/head down engaged in the pelvis at around 36 weeks. Due to the size of the foetus the possibility of cord prolapse is also increased during preterm labour.

Question 13

What is SHOULDER DYSTOSIA

Answer 13

THIS IS A TIME CRITICAL SITUATION

Normal birthing procedure fails to accomplish delivery. Occurs when the baby’s head is delivered but the shoulders cannot be delivered because they are too wide and stuck behind pubic symphysis or the opening of the birth canal.

Question 14

What is a Primary Post Partum Haemorrhage

Answer 14

Haemorrhage from the birth canal in excess of 500 millilitres during the first 24 Hours.