Week 5 Flashcards
(42 cards)
How do Braxton Hicks contractions present?
Irregular contractions that do not increase in frequency or intensity and are NOT PAINFUL (and resolve with movement)
When do Braxton Hicks contractions present?
Usually felt in the 3rd trimester but can be felt in the first 6 weeks
What is the main difference between Braxton Hicks contractions and True Labour contractions
Braxton Hicks contractions are NOT PAINFUL
What is the maximum, safe, number of contractions in 10 minutes?
3-4 contractions in 10 minutes
What are the 3 main types of pelvis?
Gynaecoid
Anthropid
Android
What are some of the pain relief options whilst in labour?
Non-opioid
Entonox
Opioid
Epidural
Remifentanyl
Define first stage of labour
From the beginning of true contractions to full dilatation
What is the latent phase of labour?
From the beginning of contractions to 4cm dilated
What is the active phase of labour?
From 4cm dilation to full dilation
What are some of the ways we can induce labour?
Prostaglandin- PGE2, dinoprostone
Mechanical- membrane sweep, foley balloon catheter
Amniotomy- artificial rupture of membranes
IV Syntocinon- this is a form of oxytocin
What are some of the risk factors for shoulder dystocia?
- previous shoulder dystocia
- fetal macrosomia
- diabetes
- BMI>30
- less than 5 foot
Complications of shoulder dystocia?
Fetal:
- hypoxia
- Brachial plexus injury
- fracture of clavicle/humerus
- intracranial haemorrhage
- death
Maternal:
- PPH
- Genital tract trauma
- pelvic injury
Which degrees of perineal tears are most common?
First degree and second degree
Which perineal tears usually require stitches?
second, third and fourth degree tears
Describe the 4 stages of perineal tears
First Degree: injury to the perineal skin only
Second Degree: injury to the perineal skin and
muscles but NOT THE ANAL SPHINCTERS
Third degree: Injury involving the anal sphincters
3A- involves part of the external anal sphincter
3B- involves all of the external anal sphincter
3C- involves the internal anal sphincter
Fourth Degree: disruption of anal epithelium/mucosa
What are some risk factors of a morbidly adherent placenta?
- previous CS
- previous uterine surgery
What are the 3 types of morbidly adherent placenta and describe each type?
Placenta accreta- the placenta is too deep within the
endometrium
Placenta increta- the placenta is buried into the
myometrium
Placenta Percreta- the placenta goes through the wall
of the uterus and can dig into other organs e.g.
bladder or bowel
Post Partum Haemorrhage management?
- ABCDE
- Uteretonics is the main mode of management
- Syntocinon (oxytocin)- first line
- Ergometrine (can be given combined with
syntocinon to form syntometrine) - Hemabate- can be given up to 8 doses- a
prostaglandin so not given for severe asthmatics - Misoprostol- prostaglandin so not given for severe asthmatics
- Tranexamic acid- stops major bleeding
- Surgical options
- Intrauterine balloon
- Brace sutures
- Interventional radiology
- Hysterecomy
What is the use of Tranexamic acid in PPH?
Helps if someone has major bleeding as slows major bleeding
What is the traditional definition of primary PPH?
More than 500ml of blood loss within 24 hours of giving birth
How long should the 3rd stage of labour last?
If actively managed , up to 30 minutes. If physiological, up to 60 minutes
How do you actively manage the 3rd stage of labour?
Uteretonics: syntocinon, syntometrine
Who should be offered active management of the 3rd stage of labour?
Prophylactic uterotonics should be routinely offered in the management of the third stage of labour in all women as they reduce the risk of PPH.
What are the advantages of actively managing the 3rd stage of labour?
Decreases length of 3rd stage
Decreases risk of PPH
