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- A 25 year old, who is 40 weeks pregnant in her first pregnancy, is in the second stage of labour. She has been actively pushing for 2 h and is exhausted. CTG shows a baseline of 150 bpm, normal baseline variability, occasional accelerations and infrequent typical variable decelerations. She is contracting 3–4 every 10 min. Vaginal examination reveals a fully dilated cervix with the fetal head in a direct occipito-anterior position and at station +1 below spines. Which of the following is the most appropriate next management step?
2. Which of the following is true for high forceps delivery?CorrectIncorrect
3. Which of the following obstetrical practices has been shown to be superior to lower the rate of intraventricular hemorrhage?CorrectIncorrect
4. 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?CorrectIncorrect
5. 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 ?CorrectIncorrect
6. 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?CorrectIncorrect
- 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?
8. 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
9. A patient has entered spontaneous premature labor at 28 weeks’ gestation. During the vertex delivery, one should do which of the following?CorrectIncorrect
- After a low forceps delivery for fetal intolerance, a mother continues to have excessive vaginal bleeding despite a well-contracted uterus. Which of the following locations is most likely to be the site of a vaginal laceration after an instrumented delivery?