How does maternal obesity affect pregnancy outcomes?

Correct Answer: A

Rationale: The correct answer is A: Increases risk of gestational diabetes. Maternal obesity can lead to insulin resistance, increasing the likelihood of developing gestational diabetes during pregnancy. This condition can have negative effects on both the mother and the baby. B: Miscarriage is not directly linked to maternal obesity but can be influenced by other factors. C: Maternal obesity is not a direct cause of anemia during pregnancy. Anemia is usually related to iron deficiency or other factors. D: Maternal obesity is actually associated with an increased risk of preterm labor, not a reduced chance. This is due to various complications such as hypertension and preeclampsia.

Correct Answer: C

Rationale: The correct answer is C because living wills typically are not always honored for cognitively impaired patients. Step-by-step rationale: A) Incorrect - A court can declare a patient incompetent if they are unable to make decisions. B) Incorrect - Impaired cognition can indeed make a person incompetent. D) Incorrect - A patient must have the capacity to understand information and make decisions to give informed consent.

Correct Answer: B

Rationale: The correct answer is B: Delay in second stage of labor. Forceps delivery is indicated when there is a delay in the second stage of labor to expedite delivery and prevent maternal and fetal complications. This could be due to factors such as maternal exhaustion, fetal distress, or ineffective pushing. Inadequate pelvis size (A) may necessitate a C-section, unsuccessful vacuum extraction (C) may require alternative interventions, and fetal distress in the first stage of labor (D) may not necessarily indicate the need for forceps delivery immediately.

Correct Answer: D

Rationale: The correct answer is D because all the choices (A, B, and C) are risks associated with cesarean sections. Infection can occur at the incision site, blood loss is a common concern during surgery, and cesarean sections typically have a longer recovery time compared to vaginal delivery. Therefore, all of these risks are potential complications of undergoing a cesarean section. The other choices (A, B, and C) are incorrect individually because they only represent a subset of the risks associated with cesarean sections, while choice D encompasses all potential risks.

Correct Answer: B

Rationale: The correct answer is B: Cyclosporine. Cyclosporine is an immunosuppressant medication commonly used post-bone marrow transplant to prevent graft-versus-host disease. It works by inhibiting T-cell activation and proliferation, reducing the risk of the donor's immune cells attacking the recipient's tissues. Immune globulin (A) is used for passive immunization, not prevention of graft-versus-host reaction. Prophylactic antibiotics (C) are used to prevent infections post-transplant, not graft-versus-host disease. Systemic corticosteroids (D) may be used to treat graft-versus-host disease but are not the first-line prophylactic medication.

Correct Answer: A

Rationale: The correct answer is A because congenital abnormalities and chorioangioma can lead to increased amniotic fluid accumulation, causing polyhydramnios. Congenital abnormalities can affect fetal swallowing and urine production, leading to fluid buildup. Chorioangioma is a vascular tumor in the placenta that can disrupt normal fluid dynamics. Choice B is incorrect as severe fetal hypoxia and multiple pregnancy are more likely to cause oligohydramnios, not polyhydramnios. Choice C is incorrect as uncontrolled diabetes mellitus and anemia are associated with macrosomia and not polyhydramnios. Choice D is incorrect because Rhesus D isoimmunisation and postdatism are not typically linked to polyhydramnios.

Correct Answer: A

Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery. Summary: B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first. C: Multiple lie - Not a recognized medical term. D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.

Correct Answer: D

Rationale: The correct answer is D, All of the above. Regular exercise helps control weight gain and improves maternal health. A balanced diet provides essential nutrients for both mother and baby. Monitoring weight gain ensures healthy weight management. Combining all three strategies optimizes outcomes by reducing risks associated with maternal obesity, such as gestational diabetes and hypertension. Each option plays a crucial role in managing maternal obesity during pregnancy for better overall health and well-being.

Correct Answer: D

Rationale: The correct answer is D: Compound. In compound presentation, a hand or foot is alongside the presenting part, usually the head. This can complicate the delivery process. A: Footling presentation means the foot presents first. B: Transverse presentation is when the baby is lying sideways. C: Cephalic presentation is normal, with the head presenting first. In this scenario, D is the correct answer as it specifically describes the situation where a hand or foot is alongside the presenting part.