Labor, Delivery, and Anesthesia
What are the stages of labor?
First - onset of contractions until fully dilated (10cm); latent and active phases
Second - from full dilation until delivery of baby
Third - from delivery of baby until deliver of placenta
Types of obstetric anesthesia and risks?
IV - early in labor; respiratory depression in neonate
Pudendal block - during delivery; risk of neurovascular injury
Spinal - Operative vaginal or cesarian; Hypotension, resp muscle paralysis, spinal headache
Epidural - labor and delivery; hypotension, spinal headache if penetrate subarachnoid. This is gold standard.
General - Emergency cesarean; resp depression in neonate, aspiration pneumonitis
Most common indications for cesarean?
Dystocia (abnormal or difficult childbirth)
What is the preferred uterine incision for cesarean?
Low transverse (Kerr)
Most common intraoperative complication?
Most common postoperative complication?
Infection - endometritis (most common) or wound infection (most troublesome)
Causes of abnormal labor?
Poor uterine contractility
What are the two PHASES of the first STAGE of labor?
Active and Latent