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31 Cards in this Set
- Front
- Back
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31. Cardinal movements of labour (just to prep)?
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1. Engagement
2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. External rotation (aka restitution or resolution) |
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32. When the fetal presenting part enters the pelvis, it is called?
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a. Engagement
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33. Descent?
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a. Head undergoes descent into the pelvis.
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34. Flexion?
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a. Allows the smallest diameter to present to the pelvis.
b. Follows descent. |
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35. Internal rotation?
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a. With descent into the mid-pelvis, the fetal vertex undergoes internal rotation from an occiput transverse (OT) position so that the sagittal suture is parallel to the AP diameter of the pelvis, commonly called occiput anterior (OA) position.
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36. Extension?
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a. As the vertex passes beneath and beyond the pubic symphysis, it will EXTEND to deliver.
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37. External rotation?
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a. Once the head delivers, the external rotation occurs and the shoulders may be delivered.
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38. Stage 1 of labour lasts from when to when?
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a. Begins w/onset of labour and lasts until dilation and effacement of the cervix are complete.
b. Average 10-12 hr in nulliparous c. 6-8 in multiparous. |
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39. Stage 2 of labour lasts from when to when?
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a. The time from full dilation until delivery of the infant.
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40. Stage 3 of labour lasts from when to when?
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a. Begins after delivery of infant and ends w/delivery of placenta
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41. 2 components of stage 1?
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a. Latent phase: From onset of labour until 3-4 cm of dilation.
b. Active phase: Follows active phase and extends until greater than 9cm of dilation and is defined by the period of time when the slope of cervical change against time increases. |
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42. At what point is stage 2 of labour considered prolonged?
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a. If duration is longer than 2 hours in a nulliparous pt, although 3 hours are allowed if pt has had epidural.
b. In multiparous women, stage 2 is prolonged if its duration is longer than 1 hour w/o an epidural and 2 hrs if w/an epidural. |
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43. Uterine hypertonus?
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a. A single contraction lasting 2 min or longer.
b. Can cause fetal bradycardia. |
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44. Uterine tachysystole?
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a. Greater than 5 contractions in a 10-minute period.
b. Can cause fetal bradycardia. |
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45. Retained placenta?
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a. Diagnosis of retained placenta is made when placenta does not deliver w/in 30 minutes.
b. Common in preterm deliveries. |
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46. What may retained placenta also be a sign of?
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a. Placenta accreta, where the placenta has invaded into or beyond the endometrial stroma.
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47. How are lacerations described?
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a. By death of tissues they involve
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48. First-degree laceration?
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a. Involves mucosa or skin.
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49. Second-degree laceration?
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a. Extends into perineal body but does not involve the anal sphincter.
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50. Third-degree laceration?
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a. Extend into or completely through the anal sphincter.
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51. Fourth-degree laceration?
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a. Occurs if the anal mucosa itself is entered.
b. Occasionally a “button-hole” 4th degree laceration will be noted. |
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52. Suturing for superficial lacerations?
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a. Interrupted sutures.
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53. Most common indication for primary C-section?
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a. Failure to progress in labour.
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54. Most common indication for C-section?
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a. Previous C-section.
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55. Other common indications for C-section?
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a. Breech presentation
b. Transverse lie c. Shoulder presentation d. Placenta previa e. Placental abruption f. Fetal intolerance of labour g. Nonreassuring fetal status h. Cord prolapse i. Prolonged second stage j. Failed operative vaginal delivery k. Actives herpes lesions |
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56. Can a vaginal birth after cesarean be performed (VBAC)?
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a. Yes, if the proper setting exists.
b. This includes: in-house obstetrician, anaesthesiologist, surgical team, and informed pt consent. c. The prior hysterotomy needs to be either a Kerr (low transverse incision) or Kronig (low vertical incision) w/o any extension into the cervix or upper uterine segment. |
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57. Greatest risk during a trial of labour after cesarean (TOLAC)?
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a. Rupture of the prior uterine scar, occurs in approx 0.5-1.0% of time.
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58. Where does the pudendal nerve run i.e. where is the pudendal nerve block given?
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a. Just posterior to the ischial spine at its juncture w/the sacrospinous ligament.
b. Anaesthetic is injected at the site b/l to give perineal anaesthesia. |
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59. At what level are Epidurals catheters placed?
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a. L3-L4 interspace.
b. Usually not given until Labour is in the active phase. |
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60. How does spinal anaesthesia differ from epidural?
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a. In that it is given in a one-time dose directly into the spinal canal leading to more rapid onset of anaesthesia.
b. It is used for commonly for C-section than for vaginal delivery. |
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61. Common complication of both epidural and spinal anesthesia?
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a. Maternal hypotension secondary to decreased systemic vascular resistance, which can lead to decreased placental perfusion and fetal bradycardia.
b. A more serious complication can be maternal respiratory depression if the anaesthetic reaches a level high enough to affect diaphragmatic innervation. |
