A fetal associated risk of prolonged pregnancy includes

Correct Answer: A

Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.

Correct Answer: D

Rationale: The correct answer is D: Postpartum eclampsia. In amniotic fluid embolism, convulsions can mimic postpartum eclampsia due to similarities in symptoms such as seizures and hypertension. However, the key differentiator is the timing of onset - postpartum eclampsia occurs after delivery, while amniotic fluid embolism typically occurs during labor or immediately postpartum. Choices A, B, and C are incorrect as they do not align with the timing and clinical presentation of amniotic fluid embolism. Antepartum eclampsia occurs before delivery, stroke presents with neurological deficits, and pre-existing epilepsy is a chronic condition unrelated to the immediate postpartum period.

Correct Answer: B

Rationale: The correct answer is B - Culture and level of education. Culture influences beliefs about pain and coping mechanisms. Education can affect understanding of pain and pain management techniques. Labor preparedness and fatigue (A) may impact pain perception but are not as influential. Age (C) alone does not determine pain perception. Number of deliveries and anxiety (D) can play a role but are not as significant as culture and education.

Correct Answer: B

Rationale: The correct answer is B: Presence of the Bandl's ring. This is indicative of an abnormal labor pattern as it may suggest a uterine rupture, which is a serious complication. Bandl's ring is a constriction ring formed between the upper and lower uterine segments due to excessive uterine contractions. It can lead to fetal distress and necessitate immediate medical intervention. A: Presence of the retraction ring is a normal phenomenon during labor, marking the boundary between the lower and upper uterine segments. C: Cervical canal short and thin can be a normal variation in labor and does not necessarily indicate an abnormal pattern. D: Vagina being warm and moist is a common physiological response during labor and does not provide information on the progress or abnormality of labor.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: D

Rationale: The correct answer is D: Escherichia coli. During puerperium, the most common causative organism of urinary tract infection is E. coli. This is because E. coli is a normal flora in the gastrointestinal tract and can ascend to the urinary tract due to factors like hormonal changes, reduced bladder tone, and trauma during delivery. Staphylococcus pyogenes (Choice A), Anaerobic streptococci (Choice B), and Clostridium welchii (Choice C) are not typically associated with urinary tract infections during puerperium. Staphylococcus pyogenes is more commonly known for causing skin infections, Anaerobic streptococci are not commonly implicated in urinary tract infections, and Clostridium welchii is associated with gas gangrene, not urinary tract infections.

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.

Correct Answer: B

Rationale: The correct answer is B: Placental insufficiency. Prolonged pregnancy can lead to decreased placental function, resulting in inadequate oxygen and nutrients for the fetus. This can lead to complications such as intra-uterine growth restriction and fetal distress. Option A (Intra-uterine oligohydramnios) is a consequence of decreased amniotic fluid levels but not directly associated with prolonged pregnancy. Option C (Fetal post-maturity syndrome) refers to the complications seen in a post-term newborn, not maternal risks. Option D (Large for gestational age baby) is a consequence of prolonged pregnancy but does not directly impact maternal health.

Correct Answer: A

Rationale: The correct answer is A because monozygotic twins, also known as identical twins, develop from a single fertilized egg and share the same genetic material. This results in them always being of the same sex. Choice B is incorrect because fingerprint patterns are not solely determined by genetics. Choice C is incorrect because monozygotic twins will have the same blood group since they share the same DNA. Choice D is incorrect because superfetation, the fertilization of multiple eggs at different times during the same pregnancy, is not common in monozygotic twins.