Interventions during childbirth

Checking Fetal Movements
1. An indirect measure of fetal wellbeing
Electronic Fetal Monitoring
1. A direct measure of fetal wellbeing
  1. Intermittent
    1. Every 15 mins in first stage and every 5 mins in second stage
    2. Uncomplicated pregnancy
    3. Healthy woman and baby
  2. Continuous
    1. Intermittent EFM shows baseline FHR under 110 or over 160
    2. Risk factors develop during labour
    3. Regular decelerations of FHR
  3. Admission CTG
    1. Not supported unless a high-risk pregnancy
2. EFM
3. EFM
4. EFM
5. EFM
6. EFM
Fetal Blood Sample
1. WHY?
  1. Determination of metabolic acidosis in fetus
    1. Reflection of tissue hypoxia
      1. Metabolic acidosis reflects high fetal morbidity
Induction of Labour
1. WHY?
  1. Woman or fetus is unwell
  2. Convenience for doctors?
  3. Social reasons for women?
  4. Post-term
  5. Psychological factors
  6. Premature rupture of membranes
  7. Preeclampsia/eclampsia
Epidural Anaesthesia
1. Most effective pain blockage available
  1. Increased rate of Caesarean sections
Caesarean Section
1. WHY?
  1. Previous caesarean section
  2. Cephalo-pelvic disproportion
  3. Breech presentation
  4. Sinister FHR
  5. Maternal request
2. C-section
External Cephalic Version
1. Breech presentation
  1. RISKS
    1. Transient bradycardia
    2. Placental abruption
    3. Vaginal bleeding
    4. Induction of labour

Zusammenfassung der Ressource

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