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29 Cards in this Set
- Front
- Back
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3. 3 Diagnostic tests to confirm rupture of membranes?
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1. Pool- Positive if there is a collection of fluid in vag.
2. Nitrazine- Vaginal secretions are normally acidic whereas amniotic fluid is alkaline so when fluid is placed on Nitrazine paper, it should turn immediately blue. 3. Fern- The oestrogens in the amniotic fluid cause crystallization of the salts in the amniotic fluid when it dries. Under microscope it looks like a fern. |
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4. What is the Bishop score?
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a. Used to diagnose a cervix favourable for both spontaneous labour and, as is more commonly used, induced labour.
b. Made up of: 5 components of cervical exam: 1. Dilation 2. Effacement 3. Fetal station 4. Cervical Position 5. Consistency of cervix. |
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5. What Bishop score is consist with favourable for both spontaneous labour and, as is more commonly used, induced labour?
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a. >8.
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6. How is dilation assessed?
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a. By using either 1 or 2 fingers to determine how open the cervic is at the internal os.
b. Range from 0 to 10cm (fully dilated) c. On avg. 10cm diameter is necessary to accommodate the term infant’s biparietal diameter. |
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7. Effacement?
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a. Subjective measurement by examiner.
b. Determines how thinned out the cervix is. c. Commonly reported by % or by cervical length. d. Typical cervix is 3-5 cm in length. So if it feels like it is about 3cm from external to internal os, it is 50% effaced. |
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8. Labour defined?
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a. Defined as contractions that cause cervical change in either effacement or dilation.
b. The diagnosis of labour strictly defined is regular uterine contractions that cause cervical change. |
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9. Prodromal labour?
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a. Aka false labour.
b. These pts usually present w/irregular contractions that vary in duration, intensity, and intervals and yield little or no cervical change. |
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10. Induction vs. augmentation of labour?
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a. Induction is the attempt to being labour in a non-labouring pt.
b. Augmentation is intervening to increase the already present contractions. |
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11. How is labour induced?
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a. W/prostaglandins, oxytocin agents, mechanical dilation of cervix, and/or artificial rupture of membranes.
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12. Indications for induction of labour?
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a. Post-term pregnancy
b. Preeclampsia c. Premature ROM d. Non-reassuring fetal testing e. Intrauterine growth restriction. f. The pt’s desire to end the pregnancy is NOT an indication for induction, but would bee deemed elective induction of labour. |
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13. What is the success of an induction of labour often correlated with?
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a. The Bishop score.
b. A Bishop score of 5 or less may lead to a failed induction as often as 50% of time. c. PGE2 and PGE1M (Misoprostol) may be used to “ripen” the cervix. |
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14. 2 Maternal contraindications to prostaglandins?
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a. Asthma and glaucoma
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15. 2 obstetric contraindications to prostaglandins?
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a. Having had more than one prior C-section and non-reassuring fetal testing.
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16. How is labour induction usually formally begun?
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a. With Pitocin (Oxytocin).
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17. Amniotomy?
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a. Labour may be induced by amniotomy.
b. It is performed by an amnio hook that is used to puncture the amniotic sac around the fetus and release some of the amniotic fluid. |
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18. Normal fetal heart rate?
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a. 110-160.
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19. What are the main concerns if fetal heart rate has a base above 160?
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a. Fetal distress secondary to:
1. Infection 2. Hypoxia 3. Anaemia. b. Also, any bradycardia w/a heart rate <90 is of concern and requires immediate action. |
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20. Definition of fetal heart rate variability?
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a. Absent (<3 beats per minute of variation)
b. Minimal (3-5 bpm of variation) c. Moderate (5-25 bpm of variation) d. Marked (>25 bpm of variation) |
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21. 3 types of fetal HR decelerations (decals)?
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1. Early decelerations
2. Variable decelerations 3. Late decelerations |
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22. Early decelerations?
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a. Begin and end approximately at the same time as contraction
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23. Variable decelerations and what do they result from?
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a. Can occur at any time and tend to drop more precipitously than either early or late decelerations.
b. They are the result of umbilical cord compression. |
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24. When do late decelerations begin and stop?
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a. They being at the peak of a contraction and slowly return to baseline after that contraction has finished.
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25. What are late decals the result of?!?
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a. Uteroplacental insufficiency and are the more worrisome type!
b. They may degrade to bradycardias as labour progresses, particularly w/stronger contractions. |
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What are early decels the result of?
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Compression of babies head-causing increased vagal tone
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26. Fetal Scalp electrode?
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a. Used in cases of repetitive decals or in fetuses who are difficult to trace externally w/a Doppler.
b. A small electrode is attached to the fetal scalp that senses the potential differences created by the depolarization of the fetal heart. c. It is more sensitive of beat to beat variation. |
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27. Contraindications to fetal scalp electrode?
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a. Hx of maternal hepatitis or HIV
b. Fetal thrombocytopenia |
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28. Monteovideo unit?
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a. The most commonly used measurement of uterine contractions.
b. It is an average of the variation of the intrauterine pressure from the baseline multiplied by the number of contractions in a 10-minute period. |
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29. Fetal Scalp pH?
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a. If the fetal heart rate tracing is nonreassuring, the fetal scalp pH may be obtained to assess for hypoxia and acidemia.
b. Fetal blood is obtained by making a small nick in the fetal scalp and drawing up a small amount of fetal blood into the capillary tubes. |
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30. When are the fetal scalp pH values reassuring?
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a. >7.25.
b. Nonreassuring when <7.20. |
