CS nice

Question 1

When providing of information

Answer 1

• Evidence based
• Accessible and in a format they understand
• Suitable and respectful language
• Keep womens concerns central in the decision making

Question 2

% of CS (overall)

Answer 2

25-30%

Question 3

Conditions requiring CS

Answer 3

• HIV (high viral load)
• Breech (offer ECV)
• Praevia/accreta
• ## Multiple preg

Question 4

Do not offer CS for

Answer 4

• Hep B/C
• Herpes, unless new in 3rd T
• High BMI
• Pelvic disproportion

Question 5

Tocophobia

Answer 5

Offer mental health support

Question 6

What factors do NOT influence CS

Answer 6

• Walking in labour
• Non-supine position in 2nd stage
• Immersion in water in labour
• Epidural
• Raspberry leaves

Question 7

Cat 1

Answer 7

Within 30min
Life threatening

Question 8

Cat 2

Answer 8

Not immediately life threatning
75min

Question 9

Cat 3

Answer 9

Needs early birth but no maternal/fetal compromise

Question 10

Cat 4

Answer 10

Planned elective birth

Question 11

Medication to maintain BP post spinal

Answer 11

Phenylephrine

Question 12

Ways to reduce infections in CS

Answer 12

• IV abx stat
• Chlorhexidine/Iodine to clean skin
• Vaginal prep if SROM

Question 13

Fetal laceration risk

Answer 13

2%

Question 14

Placenta removal

Answer 14

CCT better
Mannual removal increases risk of endometritis

Question 15

Closure of subcut tissue

Answer 15

if >2cm

Question 16

Monitoring after GA

Answer 16

GA-1:1 till
- regained airway
- heamodynamically stable
- able to communicate
then
- Obs every 30min for 2h

Question 17

Monitoring after spinal

Answer 17

• 1:1 till heamodynamically stable

Question 18

Intrathecal diamorphine

Answer 18

Hourly obs for 12h after birth

Question 19

PN pain mx after GA

Answer 19

PCA

Question 20

Catheter removal

Answer 20

Once mobile/ no sooner than 12h from top up

Question 21

Wound care

Answer 21

• Negative pressure dressing if BMI>35
• Remove standard dressing in 6-24h