W11_06 Intrapartum care, abnormal labour, obstetrical emergencies Flashcards Preview

MMMD 2 > W11_06 Intrapartum care, abnormal labour, obstetrical emergencies > Flashcards

Flashcards in W11_06 Intrapartum care, abnormal labour, obstetrical emergencies Deck (39)
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1

define labour in its two components

contractions and cervical change

2

what's an effaced cervix?

thinned out, ready for birth

3

what's a breech presentation?

baby is facing bottom down in the uterus;
complete breech is both legs and hips flexed

4

what's a Frank breech?

both hips flexed

5

what's the typical "lie" in intrapartum fetuses?

longitudinal, not transverse

6

what's the body part for reference in vertex presentations?

occiput (anterior, posterior)

7

what's the body part for reference in breech presentations?

sacrum

8

what's the body part for reference in face presentations?

chin

9

define "station" in ob/gyn

distance of the baby's head wrt the mother's ischial spine

10

what's the latent first stage?

0-3cm dilation

11

what's the active first stage?

3-10cm dilation; dilation goes more quickly in multiparous women

12

define the time of second stage

time between full dilation (10cm) to complete birth;
typically within 2 hours

13

what are the 7 cardinal movements of labour?

engagement
descent
flexion
internal rotation (occiput facing mom pubic symphysis)
extension then crowning
external rotation/restitution
expulsion/delivery

14

define the time of the third stage of labour

delivery of the fetus to the placenta;
within 30 mins

15

define the time of the fourth stage of labour

delivery of placenta to the stabilization of the patient's condition (6 hours)

16

what causes ferning of amniotic fluid?

estrogen effect

17

what's the pH of amniotic fluid?

7-7.5

18

what does green amniotic fluid mean?

warning - fetus might be passing meconium. Check the fetal heart rate and see what's going on

19

changes in FHR may precede which type of injury?

brain injury

20

what are the two types of fetal heart rate monitoring?

intermittent auscultation (e.g. with doppler);
continuous electronic fetal monitoring

21

what's the normal fetal heart rate?

110-160 bpm

22

what do we look for in electronic fetal monitoring?

uterine activity pattern;
baseline FHR;
variability and accelerations

23

what can cause variable deceleration?

cord compression

24

what do late decelerations imply?

uteroplacental insufficiency and some degree of hypoxia

25

when do late decelerations occur wrt to contractions?

AFTER the contraction

26

when do early decelerations occur wrt to contractions?

during uterine contraction;
associated with head compression, benign

27

what to do when the OB tracing is abnormal?

stop oxytocin;
reposition to left/right lateral;
improve hydration with IV fluid bolus;
perform vag exam to relieve pressure;
administer oxygen by face mask;
consider internal scalp electrode on baby;
consider fetal scalp sampling;
delivery

28

what does the fetal scalp sample look for?

pH

29

note: there are non-pharmacologic obstetrical analgesias

ok

30

what kinds of pharmacologic analgesias can we give?

pharmacologic (NO),
narcotics,
peripheral nerve blocks (pudendal),
perineal infiltration,
regional anaesthesia (epidural)

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