Part II of Week Three of Art & Science of Midwifery II

buwitawi's version from 2015-06-19 08:24

Section 1

Question Answer
What 5 pregnancy, labour, and birth characteristics make water-birth a safe option for women?1. Normal uncomplicated pregnancy 2. Uncomplicated labour pre-pool (e.g. clear liquor) 3. Established labour (at least 4-5 cm dilated) 4. Physiological third stage 5. Well informed woman
What is the correct water temperature during a labour or birth in water?35-36 degrees Celsius during labour and no higher than 38 degrees during the birth
How often should a midwife check maternal temperature and the temperature of the pool during a water birth?Hourly
Which drug is safe to use during a water birth: Pethidine or Entonox?Entonox
What reflex allows baby to be born in water?Diving relfex

Section 2

Question Answer
What are 4 common signs of OP position during palpation?1. Saucer like dip at umbilicus 2. Limbs (and movement) felt all over abdomen 3. Head may feel large 4. FHR heard at mid-line or flank
What positioning anecdotally helps babies move into an OA position?Hands and knees, forward leaning, knees below hips
What are 5 characteristics of an OP labour?1. Early SROM 2. Premature urge to push (e.g. at 5cm) 3. Back-ache 4. Slow dilation 5. Uncoordinated contractions
How is moulding diagnosed? 0 = separated sutures + = just touching ++ = over-lapping +++ = non-reducable
What can a midwife do to support an OP labour?Encourage the use of water to relieve pain, normalise, spontaneous pushing, gentle sacral pressure, movement (forward leaning)
True or false: an OP labour makes it more difficult for moulding to occur?True: the frontal bones of the baby's skull have less movement than the parietal bones (which often overlap in an OA labour)
What is a high head and increasing moulding an ominous sign of?Cephalopelvic disproportion

Section 3

Question Answer
What are the 8 mechanisms of labour?Descent, flexion, internal rotation of the head, crowing and extension of the head, restitution, internal rotation of the shoulders and external rotation of the head, lateral flexion

Section 4

Question Answer
What are 2 functions of the pelvic floor muscles?1. Support the pelvic organs 2. Prevent prolapse of the uterus and anus
How many layers of pelvic floor muscles are there and what are they called?2-superficial and deep
What are the 3 muscles of the superficial pelvic muscles?1. Ischiocavernosus 2. Bulbocavernosus 3. Transverse perinei
What are the 3 muscles of the deep pelvic muscles? 1. Iliococcygeus 2. Pubococcygeus 3. Ischiococcygeus
How do you classify a 1st degree tear?Laceration is limited to the fourchette and superficial perineal skin or vaginal mucosa
How do you classify a 2nd degree tear?Laceration extends beyond fourchette, perineal skin and vaginal mucosa to perineal muscles and fascia, but not the anal sphincter
How do you classify a 3rd degree tear?Fourchette, perineal skin, vaginal mucosa, muscles, and anal sphincter are torn
3a: partial tear of the external anal sphincter involving less than 50% thickness
3b: greater than 50% tear of the external anal sphincter
3c: internal sphincter is torn
How do you calssify a 4th degree tear?Fourchette, perineal skin, vaginal mucosa, muscles, anal sphincter, and rectal mucosa are torn
What muscles may be involved in a second degree tear?Bulbocavernosus, transverse perinei, ischiocavernosus, pubococcygeus
What muscles may be involved in a third degree tear? Bulbocavernosus, transverse perinei, ischiocavernosus, pubococcygeus, iliococcygeus, ischiococcygeus
What strategies can be used to prevent perineal trauma during labour/birth?warm packs and 'controlled' pushing during crowning
What strategies can be used to prevent perineal trauma at birth in the antenatal period?perineal massage, good hygiene, good nutrition, pelvic floor exercises
What is the % of lignocaine used during suturing?1 %
What is the dose per kg of lignocaine used during suturing?3 ml/kg
What type of vicryl is used for the majority of perineal repairsVicryl rapide 2.0
What 2 styles of suturing do we use when completing perineal repair?Continuous and sub-cutaneous