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O+G

LABOUR

PromptList and briefly define the stages of labour
ResponseFirst stage - From the onset of regular contractions to full dilatation.
Second - From full dilation to delivery of the baby.
Third - From delivery of baby to delivery of placenta.
Self-rate:
PromptDescribe your assessment of foetal wellbeing during labour
ResponseSymphesis-fundal height (estimate size vs dates)
Foetal activity - movement eg: on u/s
Foetal HR - Doppler/US
Uterine tone/presence of contractions
Uterine tenderness
Non uterine abdominal tenderness/peritonism
PV blood/fluid loss
Amniotic fluid volume
Self-rate:
PromptPrearrival preparation for woman in labour/delivery in the Emergency department (Hint: This will almost certainly be a rural emergency department)
ResponseThink: staff, stuff, space, or PASTED (Patient, Area, Staff, Teams, Equipment, Drugs)
Prepare for delivery in ED
Resuscitation room - Get help, staff with obstetric/midwifery experience, Paeds team
Baby resuscitation equipment and team
  • Resucscitaire, heater, blankets, BVM on air, adrenaline dose ready, aiwary/breathing equipment ready, umbilical line ready, suction
Mother resuscitation equipment and team
  • Monitoring, delivery pack, analgesia, IV access, syntocinon, U/S Exclude multiple births
Self-rate:
PromptCauses of PEA arrest around delivery
ResponseAmniotic fluid embolism
Thromboembolism
Cardiac issues - dissection/tamponade
CNS - SAH
Sepsis
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PromptRoutine initial management of newborn
ResponseTemperature control - warm, rub, dry
Airway - anticipate cry, stimulate if required
breathing/circulation
APGAR
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PromptIndications for resuscitation in the newborn
(Lots more in paeds)
ResponseHR < 60 - Start compressions 3:1
HR 60-100 - Ventilate with PPV (PEEP)
HR >100 - no immediate action for HR - assess other components of APGAR
Self-rate:
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