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Fetal indications for cesarean section include
- A. Impacted face presentation, shoulder presentation, locked twins.
- B. Impacted face presentation, severe pre-eclampsia, locked twins.
- C. Cephalo-pelvic disproportion, shoulder presentation, locked twins.
- D. Cephalo-pelvic disproportion, impacted face presentation, locked twins.
Correct Answer: D
Rationale: The correct answer is D because fetal indications for cesarean section typically involve situations where the baby cannot safely be delivered vaginally. Cephalo-pelvic disproportion means the baby's head is too large to pass through the mother's pelvis, necessitating a C-section. Impacted face presentation can result in difficulty during delivery, also requiring a C-section. Locked twins refer to a situation where the babies are unable to move past each other during delivery, further indicating the need for a C-section. Choices A, B, and C include some relevant indications for a C-section, but they do not encompass the full range of fetal indications like choice D does.
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In which form of hypospadias should circumcision be deferred in order to preserve the prepuce for later surgical repair?
- A. Ventral displacement
- B. Proximal displacement
- C. Midscrotal hypospadias
- D. Meatus proximal to the corona
Correct Answer: A
Rationale: The correct answer is A: Ventral displacement. In ventral displacement hypospadias, the urethral opening is located on the underside of the penis, making it necessary to defer circumcision to preserve the prepuce for later surgical repair. Preserving the prepuce in this case is important for reconstructive surgery to correct the hypospadias. Choices B, C, and D do not require deferring circumcision as the location of the urethral opening does not impact the need for prepuce preservation for future surgical repair.
What are the risks of a VBAC (vaginal birth after cesarean)?
- A. Uterine rupture
- B. Postpartum hemorrhage
- C. Placenta previa
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Uterine rupture. This is the most significant risk associated with VBAC, where the scar from the previous cesarean section may tear during labor. This can lead to severe complications for both the mother and baby. Postpartum hemorrhage (B) and placenta previa (C) are potential risks in any pregnancy but are not specifically increased in VBAC. Therefore, the correct answer is A, as it directly relates to the unique risk of VBAC.
Vaginal delivery is possible in
- A. Brow presentation
- B. Face presentation
- C. Shoulder presentation
- D. Unstable lie
Correct Answer: B
Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal.
A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery.
C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult.
D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.
Some of the neonatal complications of eclampsia are:
- A. Cerebral haemorrhage and pneumonia
- B. Severe asphyxia and prematurity
- C. Fractures and soft tissue trauma
- D. Respiratory distress and hypoglycaemia
Correct Answer: B
Rationale: The correct answer is B: Severe asphyxia and prematurity. In eclampsia, maternal hypertension can lead to placental insufficiency, reducing oxygen and nutrient supply to the fetus, resulting in severe asphyxia and premature birth. This is due to the high risk of placental abruption and intrauterine growth restriction. Other choices are incorrect because cerebral hemorrhage and pneumonia (choice A) are not commonly associated with neonatal complications of eclampsia. Fractures and soft tissue trauma (choice C) are not typical complications of eclampsia in neonates. Respiratory distress and hypoglycemia (choice D) are more commonly seen in neonates born to mothers with gestational diabetes, not eclampsia.
Signs of obstructed labor per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: The correct answer is A because signs of obstructed labor include a dry vagina due to prolonged pressure, oedema of the cervix due to prolonged contractions, and caput succedaneum which is swelling of the baby's scalp from prolonged pressure.
Choice B is incorrect because plenty of amniotic fluid is not a sign of obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Meconium-stained liquor can be a sign of fetal distress, but not specifically obstructed labor.
Choice C is incorrect because meconium-stained liquor is a sign of fetal distress, not necessarily obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Diluted urine is not a typical sign of obstructed labor.
Choice D is incorrect because while caput succedaneum is a sign of obstructed labor, oedema of the cervix is more indicative of obstructed labor than plenty of amni