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women's health - labor and delivery complications

Terms in this set (17)

prevalence of breech birth increases/decreases with increasing/decreasing gestational age
decreases, increasing

(i.e. 25% of fetuses breeched at <25 weeks)
breech presentations
-Frank: legs are extended straight upward
-Complete: extension of the legs across the anterior surface of the body
-Footling: one or both feet presenting
how is diagnosis of breech made?
physical exam, and US if confirmation is still needed.
treatment of breech presentation
external cephalic version at or near term followed by trial of vaginal delivery if successful (if not successful, planned c-section)
dystocia
abnormal labor progression
baby does not exit pelvis during childbirth despite uterine contractions due to child being physically blocked
causes of dystocia
large, abnormally positioned baby
small pelvis
problems with birth canal
3 categories of dystocia
power, passenger, passage
shoulder dystocia
failure of shoulders to deliver spontaneously after delivery of the head

obstetric emergency!!!
turtle sign
retraction of the fetal head against the mother's perineum after it emerges → shoulder dysocia
how is dystocia diagnosed
PEx and US if confirmation still needed
initial treatment for dystocia
changing posture of mother during labor
first line treatment for shoulder dystocia
non-manipulative maneuvers → suprapubic pressure or McRoberts maneuver
McRoberts maneuver
sharp flexion of the maternal hips

(non-manipulative maneuver to treat shoulder dystocia)
first line treatment of shoulder dystocia failed, what do you try next?
manipulative maneuvers → Wood's corkscrew or delivery of posterior arm
Wood's corkscrew
pressure behind posterior shoulder to rotate/dislodge anterior shoulder*
non-manipulative and manipulative maneuvers failed, what is the next treatment for dystocia
pushing fetal head back into canal and transferring for emergent c-section
reactive NST
2 accelerations > 15 bpm for 15 seconds in 20 minutes
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