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- Ms XY is primigravida at 41/40 weeks in spontaneous labour. She is Indian (Asian ethnicity) and has a baby in direct OP position. She has been pushing for 2 h and using epidural analgesia. She has been consented for a trial of instrumental delivery in theatre as birth is not imminent. Which of the following risk factors has the strongest association with obstetric anal sphincter injury?
- A senior midwife calls you to the delivery suite. A primigravida during a normal delivery sustains a perineal tear. Which of the following statements is incorrect regarding the degree of perineal tears?
- You are seeing a 32-year-old para 2 woman at 16 weeks’ gestation in the antenatal clinic. She had two previous normal vaginal deliveries, but sustained a third-degree tear during her second delivery. She is asymptomatic and is anxious about the risk of recurrence in this pregnancy. What is her risk of sustaining another third- or fourth-degree tear in this pregnancy?
- 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)?
- A nulliparous woman had a trial of instrumental delivery in theatre for failure to progress in the second stage of labour. She sustained a fourth-degree tear with 1 cm of the anal mucosa torn during the forceps delivery. Which one of the suture materials should be used to repair the anorectal mucosa?
- Ms. XY is in theatre recovery after repair of a 3B perineal tear. You come to debrief her about the procedure. What percentage of women are asymptomatic after EAS repair at 12 months ?
- You are explaining the plan of antenatal care to a woman who has come for a booking visit. Her last menstrual period was about 9 weeks back and she had a positive urine pregnancy test last week. You will offer her an ultrasound scan between 10 weeks and 13 weeks and 6 days for the following reason:
- Ms XY is a primigravida at 37 weeks. She has had low risk uncomplicated pregnancy so far. She has presented to the labour suite complaining of reduced fetal movements for 1 day. CTG is normal/reactive. She continues to perceive reduced movements despite a normal CTG. Which of the following treatment options are best suited to her?
- Ms XY presents to the labour suite with a second episode of reduced fetal movements. She is 17 years old, Para 0, 39 weeks pregnant. She is smoker and has poor access to care. CTG is reassuring/reactive, and an ultrasound scan reveals abnormally grown fetus, with normal liquor volume and normal umbilical artery doppler. Which of the following treatment options are best suited to her?
- You are counselling a 28-year-old primigravida with a singleton pregnancy at the antenatal clinic at 38 weeks regarding her options for delivery. Her clinical history has been normal so far and is perceiving good fetal movements, and she has a fetus in cephalic presentation. Which of the following statements is incorrect?