Abnormal Labour

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( 60%, 40%, 80% ) of pregnancies are delivered vaginally with no complications
( 25%, 10%, 40% ) of pregnancies are delivered by c-section

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The anterior and posterior fontanelles along with the parietal eminences make up which area of the foetal skull?
The

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Pre-term is defined as delivery before ( 37 weeks, 36 weeks, 38 weeks )
Post-term is defined as delivery after ( 42 weeks, 40 weeks, 41 weeks )

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Name the following types of breech presentation:

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The type of breech presentation whereby the baby presents bottom first due to having their feet by their head is known as a breech

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Failure to progress is defined as ( <2cm, <4cm ) cervical dilation in ( 4, 6, 8 ) hours

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Progression of the foetus through the maternal pelvis is quantified in relation to which bony landmarks?
The

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A foetal progression of +3 would suggest that the baby is around 3cm ( below, above ) the ischial spines

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What are the 3 Ps in relation to failure to progress? (shorted word to longest):

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The is used to record graphical information about the progress of labour in which the information about the fetal well-being, maternal well-being and the progress of labour are recorded onto a single chart

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Syntocinon is the synthetic form of the hormone that is used to induce uterine contractions in labour

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The chart on which the foetal heart rate is monitored alongside maternal uterine contractions is known as the (don't use abbreviation)

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Cardiotocograms (CTGs) are analysed using the acronym DR C BRAVADO. What do the letters stand for?
DR -
C -
BRA -
V -
A -
D -
O - Judgement

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In terms of analysing the CTG, the Baseline Rate refers to the foetal heart rate. What is the normal foetal heart rate?
Between ( 100-160, 100-140, 120-140, 120-160 ) BPM

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In terms of analysing the CTG, the variability refers to the change in the foetal heart rate from one beat to the next. In a healthy foetus, the variability is between ( 5-25, 5-10, 10-20, 15-25 ) BPM

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In terms of analysing the CTG, accelerations are abrupt increases in the foetal heart rate of >( 15, 5, 10 )BPM for >( 15, 5, 10 ) seconds

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In terms of the CTG, accelerations occurring alongside contractions are ( normal, abnormal ) and reassuring of ( a healthy, an unhealthy ) foetus

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In terms of analysing the CTG, decelerations are abrupt decreases in the foetal heart rate of >( 15, 5, 10 )BPM for >( 15, 5, 10 ) seconds

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Decelerations can be early, late or variable:
❌: Occur exactly in time with uterine contractions and recover by the time the contraction is over
❌: Have a variable recovery time
❌: Occur at the peak of a contraction and don’t recover until after the contraction is over

Early decelerations

Variable decelerations

Late decelerations

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Which type of decelerations are usually caused by cord compression?

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Which type of deceleration is considered normal and expected on a CTG?

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Which type of decelerations are almost always a sign of foetal distress and should be thoroughly investigated?

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Which 2 sites can you take blood from to determine if a foetus is hypoxic?

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If the foetal blood pH is ( under 7.2, under 7.3, over 7.4, over 7.5 ) the baby is likely to be hypoxic and should be delivered

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Assisted Vaginal Delivery typically involves these two tools. What are they called?

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In the case of failure to progress in labour (without epidural anaesthesia), how long would you try for a spontaneous vaginal delivery before attempting assisted vaginal delivery?
Primigravida = ( 2 hours, 1 hour )
Multiparous = ( 1 hour, 2 hours )

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Ventouse delivery is typically more effective that a forceps delivery

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Which condition, characterised by a deep rooted placenta, becomes more likely in subsequent pregnancies if a woman is to have a caesarean section?

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Which of the following warrants immediate foetal blood sampling?

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A foetal blood sample indicates that the blood is more acidic than it should be. What is your next move?

Abnormal Labour lecture given on the Thursday morning of Week 4

Abnormal Labour

60% 40% 80%( 60%, 40%, 80% ) of pregnancies are delivered vaginally with no complications 25% 10% 40%( 25%, 10%, 40% ) of pregnancies are delivered by c-section

The anterior and posterior fontanelles along with the parietal eminences make up which area of the foetal skull? The

Pre-term is defined as delivery before 37 weeks 36 weeks 38 weeks( 37 weeks, 36 weeks, 38 weeks ) Post-term is defined as delivery after 42 weeks 40 weeks 41 weeks( 42 weeks, 40 weeks, 41 weeks )

Name the following types of breech presentation:

The type of breech presentation whereby the baby presents bottom first due to having their feet by their head is known as a breech

Failure to progress is defined as <2cm <4cm( <2cm, <4cm ) cervical dilation in 4 6 8( 4, 6, 8 ) hours

Progression of the foetus through the maternal pelvis is quantified in relation to which bony landmarks? The

A foetal progression of +3 would suggest that the baby is around 3cm below above( below, above ) the ischial spines

What are the 3 Ps in relation to failure to progress? (shorted word to longest):

The is used to record graphical information about the progress of labour in which the information about the fetal well-being, maternal well-being and the progress of labour are recorded onto a single chart

Syntocinon is the synthetic form of the hormone that is used to induce uterine contractions in labour

The chart on which the foetal heart rate is monitored alongside maternal uterine contractions is known as the (don't use abbreviation)

Cardiotocograms (CTGs) are analysed using the acronym DR C BRAVADO. What do the letters stand for? DR - C - BRA - V - A - D - O - Judgement

In terms of analysing the CTG, the Baseline Rate refers to the foetal heart rate. What is the normal foetal heart rate? Between 100-160 100-140 120-140 120-160( 100-160, 100-140, 120-140, 120-160 ) BPM

In terms of analysing the CTG, the variability refers to the change in the foetal heart rate from one beat to the next. In a healthy foetus, the variability is between 5-25 5-10 10-20 15-25( 5-25, 5-10, 10-20, 15-25 ) BPM

In terms of analysing the CTG, accelerations are abrupt increases in the foetal heart rate of >15 5 10( 15, 5, 10 )BPM for >15 5 10( 15, 5, 10 ) seconds

In terms of the CTG, accelerations occurring alongside contractions are normal abnormal( normal, abnormal ) and reassuring of a healthy an unhealthy( a healthy, an unhealthy ) foetus

In terms of analysing the CTG, decelerations are abrupt decreases in the foetal heart rate of >15 5 10( 15, 5, 10 )BPM for >15 5 10( 15, 5, 10 ) seconds

Decelerations can be early, late or variable: ❌: Occur exactly in time with uterine contractions and recover by the time the contraction is over ❌: Have a variable recovery time ❌: Occur at the peak of a contraction and don’t recover until after the contraction is over

Which type of decelerations are usually caused by cord compression?

( 60%, 40%, 80% ) of pregnancies are delivered vaginally with no complications
( 25%, 10%, 40% ) of pregnancies are delivered by c-section

The anterior and posterior fontanelles along with the parietal eminences make up which area of the foetal skull?
The

Pre-term is defined as delivery before ( 37 weeks, 36 weeks, 38 weeks )
Post-term is defined as delivery after ( 42 weeks, 40 weeks, 41 weeks )

Failure to progress is defined as ( <2cm, <4cm ) cervical dilation in ( 4, 6, 8 ) hours

Progression of the foetus through the maternal pelvis is quantified in relation to which bony landmarks?
The

A foetal progression of +3 would suggest that the baby is around 3cm ( below, above ) the ischial spines

Cardiotocograms (CTGs) are analysed using the acronym DR C BRAVADO. What do the letters stand for?
DR -
C -
BRA -
V -
A -
D -
O - Judgement

In terms of analysing the CTG, the Baseline Rate refers to the foetal heart rate. What is the normal foetal heart rate?
Between ( 100-160, 100-140, 120-140, 120-160 ) BPM

In terms of analysing the CTG, the variability refers to the change in the foetal heart rate from one beat to the next. In a healthy foetus, the variability is between ( 5-25, 5-10, 10-20, 15-25 ) BPM

In terms of analysing the CTG, accelerations are abrupt increases in the foetal heart rate of >( 15, 5, 10 )BPM for >( 15, 5, 10 ) seconds

In terms of the CTG, accelerations occurring alongside contractions are ( normal, abnormal ) and reassuring of ( a healthy, an unhealthy ) foetus

In terms of analysing the CTG, decelerations are abrupt decreases in the foetal heart rate of >( 15, 5, 10 )BPM for >( 15, 5, 10 ) seconds

Decelerations can be early, late or variable:
❌: Occur exactly in time with uterine contractions and recover by the time the contraction is over
❌: Have a variable recovery time
❌: Occur at the peak of a contraction and don’t recover until after the contraction is over

If the foetal blood pH is ( under 7.2, under 7.3, over 7.4, over 7.5 ) the baby is likely to be hypoxic and should be delivered

In the case of failure to progress in labour (without epidural anaesthesia), how long would you try for a spontaneous vaginal delivery before attempting assisted vaginal delivery?
Primigravida = ( 2 hours, 1 hour )
Multiparous = ( 1 hour, 2 hours )