Management of labour

What is the risk of preterm birth if there was 1, 2 or 3 previous preterm births?

1 - 17%

2 - 35%

3 - 67%

When should history vs ultrasound indicated cerclage be inserted?

history - after the booking scan 11-14

ultrasound after the anomaly scan

how long does emergency cerclage delay delivery by?

34 days

what percentage of pregnancies are affected by PPROM?

3%

Abx for post natal endometritis

clindamycin + gentamycin

Main cause of litigation in labour with regards to CTG

failure to recognise abnormal CTG

Red features for decelarations in CTG

• acute bradycardia >3 min

• late decelerations

• variable decelerations more than 30 min

What is the risk of DIC with IUFD within 4 weeks?

10%

Which non invasive investigations are used for IUFD and what are they best for?

Ultrasound - brain imaging

MRI - cardiac abnormalities

risk of >1L PPH in active vs physiological management

Physiological 29 in 1000

Active 13 in 1000

Best position in labour

with epidural - lateral

without epidural - upright

what is the commonest cause of transfer to obstetrics led unit and in what percent

delay in first and second stage 35%

What is the type of suture in third and fourth degree?

3a - end to end 3-0 PDS

3b - end to end or overlapping 3-0 PDS

3c - mattress 3-0 PDS

4 - interrupted or continuous 3-0 vicryl

What is the smallest and largest presenting diameter

smallest

• submento bregmatic or sub occipital bregmatic 9.5cm

• largest occipmento vertical 13.5