BCIT - Module 5B
What is labour dystocia? correct answersLong, difficult,
abnormal labour Generally d/t variance in one of the 5 P's
Leading cause of caesarean birth
Variances may be anticipated or unanticipated
What factors increase the risk of labour dystocia? correct
answersObesity Short stature
Advanced maternal
age Infertility
Uterine abnormalities
Malpresentation, malposition
Overstimulation of uterus with
oxytocin Maternal fatigue,
dehydration, fear Use of epidural
analgesia
What variations with the passenger can cause labour dystocia? correct
answersFetal Size - LGA
Cephalopelvic disproportion - head too big to move through pelvis
What cues will lead you to suspect macrosomia? correct
answersSFH>Gestational age Woman does not experience lightening
Excess weight gain during
pregnancy Partner who is above
average wt/ht
What S&S may occur if the fetus is too large? correct answersChanges in
contraction pattern
Changes in FHR
Possible uterine
rupture
VE may show
molding and caput
What are some common signs of CPD? correct answersMolding early
in labour Descent/rotation not occurring
Molding is excessive or increasing
What is caput? correct answersCaput Succedaneum - generalized edema on
fetal scalp Worsening caput with no descent may indicate CPD
What is a cephalhematoma? correct answersCollection of blood between the
skull bone and periosteum
, What is shoulder dystocia? correct answersObstetrical emergency -
shoulders caught on pubic arch, cannot pass under for delivery
May cause fetal asphyxia, fractures to humerus or clavicle, and brachial
nerve plexus injuries
May cause maternal PP hemorrhage, trauma and rectal injuries
What clues would cause you to anticipate possible shoulder
dystocia? correct answersSlow crowning of fetal head
Difficulty delivering face or
chin Head recoils against the
perineum
No spontaneous restitution and external
rotation Failure of shoulders to descend
Failure to deliver with maternal expulsive
efforts
Inability to deliver fetal shoulders with
gentle pressure alone
Define "malpresentation" correct answersSomething other than the
head is the presenting part
What are the various types of breech presentation? correct answersFrank
breech - hips flexed, knees extended
Complete breech - hips and knees flexed
Footling breech - one or both feet present before the buttocks
What is external cephalic version? correct answersObstetrician tries to turn
fetus from breech to cephalic by pressing on the woman's abdomen
Define "malposition" correct answersAny fetal head engagement position
other than occiput transverse -> occiput anterior
Most common is a persistent occiput posterior position
When the fetus is OP, the woman may experience a long, slow labour with a
lot of back pain
What can be done to assist with the correction of malposition? correct
answersMaternal positioning - upright leaning, lunging, and rocking to help
fetus descend
Digital or manual manipulation of the fetal head by a physician may be
possible with FHR monitoring
What are some common variations in passage that can cause labour
dystocia? correct answersSize and shape of pelvis determined by genetics
Pelvic contractures or deformities
Soft tissue obstructions (placenta previa, uterine fibroids, tumours, full
bladder/rectum)
What is a persistent cervical lip? correct answersThin ribbon or lip of
cervix which persists into second stage labour
Often associated with OP position and a strong urge to push prior to full
dilatation
What is labour dystocia? correct answersLong, difficult,
abnormal labour Generally d/t variance in one of the 5 P's
Leading cause of caesarean birth
Variances may be anticipated or unanticipated
What factors increase the risk of labour dystocia? correct
answersObesity Short stature
Advanced maternal
age Infertility
Uterine abnormalities
Malpresentation, malposition
Overstimulation of uterus with
oxytocin Maternal fatigue,
dehydration, fear Use of epidural
analgesia
What variations with the passenger can cause labour dystocia? correct
answersFetal Size - LGA
Cephalopelvic disproportion - head too big to move through pelvis
What cues will lead you to suspect macrosomia? correct
answersSFH>Gestational age Woman does not experience lightening
Excess weight gain during
pregnancy Partner who is above
average wt/ht
What S&S may occur if the fetus is too large? correct answersChanges in
contraction pattern
Changes in FHR
Possible uterine
rupture
VE may show
molding and caput
What are some common signs of CPD? correct answersMolding early
in labour Descent/rotation not occurring
Molding is excessive or increasing
What is caput? correct answersCaput Succedaneum - generalized edema on
fetal scalp Worsening caput with no descent may indicate CPD
What is a cephalhematoma? correct answersCollection of blood between the
skull bone and periosteum
, What is shoulder dystocia? correct answersObstetrical emergency -
shoulders caught on pubic arch, cannot pass under for delivery
May cause fetal asphyxia, fractures to humerus or clavicle, and brachial
nerve plexus injuries
May cause maternal PP hemorrhage, trauma and rectal injuries
What clues would cause you to anticipate possible shoulder
dystocia? correct answersSlow crowning of fetal head
Difficulty delivering face or
chin Head recoils against the
perineum
No spontaneous restitution and external
rotation Failure of shoulders to descend
Failure to deliver with maternal expulsive
efforts
Inability to deliver fetal shoulders with
gentle pressure alone
Define "malpresentation" correct answersSomething other than the
head is the presenting part
What are the various types of breech presentation? correct answersFrank
breech - hips flexed, knees extended
Complete breech - hips and knees flexed
Footling breech - one or both feet present before the buttocks
What is external cephalic version? correct answersObstetrician tries to turn
fetus from breech to cephalic by pressing on the woman's abdomen
Define "malposition" correct answersAny fetal head engagement position
other than occiput transverse -> occiput anterior
Most common is a persistent occiput posterior position
When the fetus is OP, the woman may experience a long, slow labour with a
lot of back pain
What can be done to assist with the correction of malposition? correct
answersMaternal positioning - upright leaning, lunging, and rocking to help
fetus descend
Digital or manual manipulation of the fetal head by a physician may be
possible with FHR monitoring
What are some common variations in passage that can cause labour
dystocia? correct answersSize and shape of pelvis determined by genetics
Pelvic contractures or deformities
Soft tissue obstructions (placenta previa, uterine fibroids, tumours, full
bladder/rectum)
What is a persistent cervical lip? correct answersThin ribbon or lip of
cervix which persists into second stage labour
Often associated with OP position and a strong urge to push prior to full
dilatation
