Fetal monitoring

During delivery, you’ll most certainly be asked to keep an eye on the fetal heart monitoring strip.

“VEAL CHOP” is a memory trick to remember what each of the patterns mean. The first word of the mnemonic, “veal”, represents the different patterns you may observe. The second word, “chop”, tells you what each pattern indicates about the state of the fetus. The first letter of “veal” corresponds with the first letter of “chop”, the second letter of “veal” corresponds with the second letter of “chop”. etc.

V = variable

E = early accelerations

A = accelerations

L = late decelerations

C = cord compression

H = head compression

O = OK (i.e. it’s all good!)

P = placental insufficiency

“HELP VC” is another one you can use to remember the causes of decelerations

HE = head compression –>early

LP = late–>placental insufficiency

VC = variable–> cord compression

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Have a great week! Thanks for reading. Happy studying.

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Abnormal labour

This week, The WM is continuing with the obstetrics theme.

What does one have to consider when labour is not progressing as expected? Easy. Think of the “3 P’s”!

  • Passenger: infant size, presentation (occiput anterior, posterior, or transverse)
  • Passage: size, shape, and adequacy of the pelvis
  • Power: uterine contractility

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Post-partum hemorrhage

If a woman bleeds more than 500 cc of blood after delivery, she is considered to have post-partum hemorrhage (PPH). In order to resolve this, the cause of the bleeding should be identified. The differential for PPH is described by the “4 Ts”

T = Decreased uterine Tone (the most common cause of PPH)
T = Trauma (e.g. cervical/vaginal laceration, uterine inversion, uterine rupture)
T = Tissue (e.g. placenta accreta, retained placenta)
T = Thrombin (i.e. coagulopathy)

 

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Thanks for reading! Have a great week.

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