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1.A 34-year-old para 2 woman with two previous normal deliveries comes in spontaneous labour at 40 weeks’ gestation. She was low risk and was found to be in established labour at 6 cm cervical dilatation with intact membranes. A few hours after this examination, she had spontaneous rupture of membranes, fully dilated cervix and a brow presentation. What is the diameter of the presenting part?CorrectIncorrect
2.A 28-year-old woman with a past history of a third-degree tear was admitted in established labour and progressed well. She was in the second stage of labour and was actively pushing with good descent. Which one of the following would be most appropriate in preventing the obstetric anal sphincter injuries (OASIS)?CorrectIncorrect
3.What is the risk of umbilical cord prolapse in breech presentation?CorrectIncorrect
4.You were asked to see a 29-year-old nulliparous woman in the active second stage of labour, pushing for about an hour and exhausted, asking for a caesarean section. She was induced at 38 weeks for type 1 diabetes and suspected macrosomia. She is contracting 4 in 10 minutes and the CTG is normal. Per abdomen, 0/5th head was palpable and you have confirmed full dilatation, absent membranes, right occipito-posterior (ROP) position with the vertex at spines and descent to +1 during pushing. What is the most appropriate management plan?CorrectIncorrect
5.A nulliparous woman at 40 + 2 gestation was admitted in spontaneous labour and progressed satisfactorily to full dilatation 2 hours ago. On reassessment there is no change in the descent with the vertex at −1 station, the position is occipitoanterior with absent membranes, no caput or moulding. Epidural is effective, contractions are three in 10 minutes and the CTG is normal. What is the most appropriate management?CorrectIncorrect
6.A 34-year-old nulliparous woman in the second stage of labour has been pushing for
the last two hours and is exhausted. The CTG is normal; the head is 1 cm above the
ischial spines, in occipitoanterior position.
Which of the following would be the most appropriate action?CorrectIncorrect
7.A 23-year-old nulliparous woman has been pushing for two hours. The head is not
palpable abdominally, the cervix is fully dilated, and on vaginal examination, the
head is in right occipitoposterior position with minimal caput. The station is 1 cm
below the ischial spine. The CTG is reassuring.
Which of the following management options would be the most appropriate?CorrectIncorrect
8.Which type of episiotomy would be most appropriate to reduce the risk of severe
9.A 33-year-old woman in her second pregnancy presents to the labour ward at 39 weeks with painful uterine contractions every three minutes. Vaginal examination shows the cervix to be dilated 6 cm and effaced. The head is 3 cm above the ischial spines. The membranes are ruptured. You could easily feel the anterior fontanel and the supraorbital ridges. Fetal heart rate is normal. Her first pregnancy ended in a normal uncomplicated vaginal delivery. Which of the following is the best management option?CorrectIncorrect
10.A patient in early labour enquires about the risk of accidental dural puncture if she has epidural analgesia. What is the risk of dural puncture?CorrectIncorrect
11.A 18-year-old young girl is induced at 38 weeks because of mild pre-eclampsia. She wants to know how she would benefit from continuous electronic fetal monitoring as she felt it may limit her freedom of movement during labour. What will you tell her?CorrectIncorrect
12.A 27-year-old primigravida attends the labour ward complaining of irregular contractions. She is 38 weeks pregnant. The ultrasound scan performed at 36 weeks showed the placenta to be posterior and high, with a normally grown baby. Her admission cardiotocography (CTG) shows a baseline rate of 145 beats per minute (bpm), variability of 10–15 bpm, accelerations, no decelerations, and she is contracting once every 10 minutes. Vaginal examination showed the cervix to be partially effaced and dilated 2 cm with intact membranes. The head is 5/5 palpable. All her observations are normal. Which of the following options would you do next?CorrectIncorrect
13.A 22-year-old in her first pregnancy is induced at term plus. ; she was dilated 6 cm four hours previously and now is dilated 8 cm on vaginal examination. She has uterine contractions at a rate of two every 10 minutes. The CTG shows a baseline rate of 150 bpm, good variability and infrequent shallow variable deceleration. What is the next most appropriate action?CorrectIncorrect
14.A 36-year-old nulliparous woman in the second stage of labour has been pushing for 30 minutes. The CTG shows a fetal heart rate of 170 bpm, reduced variability and late decelerations having occurred for the last 25 minutes. Vaginal examination shows the head to be at the ischial spines in occipitoposterior position. Which of the following management options would be most appropriate?CorrectIncorrect
15.A 36-year-old woman with three previous Caesarean sections was booked for repeat elective Caesarean section at 39 weeks. She declined tubal ligation as she wishes to have more children. What is her risk of placenta praevia in her next pregnancy?CorrectIncorrect