Fetal indications for cesarean section include

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: C

Rationale: The correct answer is C: Diamorphine. Diamorphine is a non-pharmacological measure of pain relief in labor. It is a type of opioid analgesic that helps to reduce pain during labor. It works by binding to opioid receptors in the brain and spinal cord, altering the perception of pain. Rationale: 1. Diamorphine is a medication that directly targets pain relief. 2. It is a commonly used non-pharmacological measure in labor settings. 3. Diamorphine does not involve the use of any gases or inhalants like Entonox (A) or Cyclothane (B). 4. Homeopathy (D) is based on the principle of treating "like with like" using highly diluted substances and is not typically used for pain relief in labor. Summary: A: Entonox and B: Cyclothane are incorrect because they are pharmacological measures involving the use of gases or inhalants. D: Homeopathy is

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.

Correct Answer: C

Rationale: The correct answer is C: Gastric retention. Mrs. Coates' symptoms of persistent and progressive discomfort are not likely due to gastric retention because she underwent a duodenal resection for a bleeding ulcer, which would bypass the stomach. Therefore, gastric retention is not a possible cause. A: Colic due to return of peristalsis is a possible cause as peristalsis returning after surgery can cause discomfort. B: Leakage from the duodenal stump is a possible cause as it can lead to abdominal discomfort postoperatively. D: Hemorrhage is a possible cause given her history of bleeding ulcer and surgery.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Precipitate labor is defined as unusually rapid labor. 2. Option A states that it is concluded in less than three hours, aligning with the definition. 3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor. 4. Option C contradicts the definition as it mentions a duration longer than three hours. 5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor. Summary: Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.

Correct Answer: D

Rationale: The correct answer is D because both statements A and C are true. Older mothers have a higher risk of developing preeclampsia due to age-related complications. Additionally, advanced maternal age is associated with an increased likelihood of requiring a cesarean section due to factors like decreased uterine elasticity. Statement B is incorrect as younger mothers are not at higher risk of miscarriage compared to older mothers. This is because maternal age is not a significant factor in miscarriage risk.

Correct Answer: B

Rationale: The correct answer is B. It is important to manage medications appropriately preoperatively to minimize complications. Metoprolol, a beta blocker, should be continued up until the day of surgery to prevent rebound hypertension or tachycardia. Metformin should be held on the day of surgery to avoid potential lactic acidosis due to its effects on kidney function. Warfarin should be discontinued 5-7 days before surgery to reduce the risk of bleeding. Vitamin E can increase bleeding risk and should be discontinued. Choice A is incorrect as not all medications should be taken until the morning of surgery. Choice C is incorrect as warfarin should be held earlier than 5 days before surgery. Choice D is incorrect as metformin should be held on the day of surgery, regardless of blood sugar levels, to prevent lactic acidosis.

Correct Answer: D

Rationale: Rationale for Correct Answer (D: Atelectasis): 1. Ascorbic acid deficiency can lead to impaired collagen synthesis, affecting lung tissue integrity. 2. Anemia reduces oxygen-carrying capacity, increasing the risk of lung collapse. 3. Volume contraction can lead to decreased lung compliance, predisposing to atelectasis. Summary of Incorrect Choices: A: Prolonged intubation is more related to airway issues, not specifically affected by the mentioned risk factors. B: Thromboembolism is more linked to blood clotting issues rather than the mentioned risk factors. C: Delayed wound healing is more influenced by nutritional deficiencies and blood flow, not directly linked to lung complications like atelectasis.

Correct Answer: A

Rationale: The correct answer is A because Bishop's score assesses the readiness of the cervix for labor by evaluating descent (station of the fetal head), presentation (fetal position), and cervical dilatation, which are key indicators of cervical ripening and effacement. Descent shows the progress of the fetus through the birth canal, presentation indicates the fetal position for delivery, and cervical dilatation reflects the opening of the cervix for labor. Choices B, C, and D are incorrect as they do not encompass all the essential components of Bishop's score, which focuses on descent, presentation, and cervical dilatation.