Labor, Delivery, and Anesthesia

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created 10 years ago by stefan_mcfarland
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Lecture 17, Med 2, Spring 2013, UFPA 2014
Grade levels:
Graduate school, Professional
Subjects:
ob/gyn
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1

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

2

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

3

Most common indications for cesarean?

Dystocia (abnormal or difficult childbirth)
Previous cesarean
Distress
Bleeding
Malpresentation

4

What is the preferred uterine incision for cesarean?

Low transverse (Kerr)

5

Most common intraoperative complication?

hemorrhage

6

Most common postoperative complication?

Infection - endometritis (most common) or wound infection (most troublesome)

7

Causes of abnormal labor?

Poor uterine contractility
Over sedation
Intrauterine infection
Malpresentation
Malposition
Fetopelvic disproportion

8

What are the two PHASES of the first STAGE of labor?

Active and Latent