What are common complications of multiple gestations?

Correct Answer: D

Rationale: The correct answer is D: All of the above. Multiple gestations are at higher risk for complications such as premature labor, where contractions start before 37 weeks, leading to preterm birth. Twin-to-twin transfusion syndrome can occur in identical twins sharing a placenta, causing unequal blood flow. Preeclampsia, characterized by high blood pressure and organ damage, is more common in multiple pregnancies. Therefore, all choices A, B, and C are correct as they are common complications associated with multiple gestations.

Correct Answer: C

Rationale: The correct answer is C: A long history of alcohol use. In this case, the patient T. S. is brain dead following a catastrophic accident. Although she had an organ donor notation, her long history of alcohol use precludes her from serving as a liver donor. Chronic alcohol use can lead to liver damage and compromise the quality of the liver for transplantation. Encephalopathy (choice A) is a potential complication of liver disease, but it does not preclude her from being a liver donor. Hepatitis C infection (choice B) and biliary cirrhosis (choice D) may affect the liver, but they do not automatically disqualify her as a donor.

Correct Answer: B

Rationale: Postdatism refers to a pregnancy that extends beyond the normal gestation period of 280 days. The correct answer is B (294 days) as it is more than the standard 280-day term. Choice A (280 days) is the normal term, not postdatism. Choices C (290 days) and D (287 days) are also below the 294-day mark, making them incorrect for defining postdatism.

Correct Answer: A

Rationale: The correct answer is A because secondary postpartum hemorrhage typically occurs between the 8th-14th day postpartum and can extend up to 6 weeks after delivery. This timeframe aligns with the physiological changes and healing process after childbirth. Choice B is incorrect because it contradicts the established timeframe for secondary postpartum hemorrhage. Choice C is incorrect as secondary postpartum hemorrhage is not rare but rather a recognized complication that can occur after childbirth. Choice D is incorrect as secondary postpartum hemorrhage does not happen sporadically, but rather follows a defined timeframe based on postpartum physiological changes.

Correct Answer: C

Rationale: The correct answer is C: Precipitate labor. Precipitate labor refers to a rapid labor and delivery process. It is matched with the statement in column A because it is associated with a sudden and quick progression of labor, leading to a rapid delivery of the baby. The other choices are incorrect because: A: Colicky uterus - This term is not related to rapid labor but rather refers to uterine contractions that are painful and intermittent. B: Constriction ring dystocia - This term describes a condition where there is a tight band around the uterus, causing difficulty in the delivery process, which is different from the rapid progression seen in precipitate labor. D: Cervical dystocia - This term refers to a condition where there are issues with the dilation or effacement of the cervix, not directly related to the speed of labor as in precipitate labor.

Correct Answer: B

Rationale: The correct answer is B because pressure applied on the cervix by the presenting part in obstructed labor leads to edema of the vulva. This pressure causes obstruction of blood and lymphatic flow in the area, resulting in swelling and edema. Prolonged effort by the mother (choice A) would not directly cause vulvar edema. An ill-fitting presenting part (choice C) may contribute to obstruction but does not explain the mechanism of edema. Large presenting diameters (choice D) stretching the vulva would not directly cause edema without pressure on the cervix.

Correct Answer: A

Rationale: The correct answer is A: Rhesus D incompatibility. Icterus gravis (severe jaundice) and hydrops fetalis (abnormal accumulation of fluid) are both conditions commonly associated with Rhesus D incompatibility between a mother and her fetus. This occurs when the mother is Rh-negative and the fetus is Rh-positive, leading to maternal antibodies attacking the fetal red blood cells, resulting in severe hemolytic anemia and subsequent complications. Explanation for why other choices are incorrect: B: ABO incompatibility typically leads to less severe jaundice and hemolytic disease compared to Rhesus D incompatibility. C: Physiological jaundice is a common and benign condition in newborns caused by the immaturity of the liver, not by blood type incompatibility. D: Instant perinatal death is not specifically associated with these conditions, but rather with other serious complications during childbirth.

Correct Answer: C

Rationale: Rationale: Face to pubis delivery occurs when the fetal face presents towards the mother's pubic bone during birth. Choice C is correct because a 45˚ anterior rotation of the occiput is needed for this positioning. This allows the fetal face to be directed towards the mother's pubis for a successful face to pubis delivery. Choices A and D are incorrect as they mention incorrect angles of rotation. Choice B is incorrect as a persistent occipito posterior position would result in a face to sacrum delivery, not face to pubis.

Correct Answer: B

Rationale: The correct answer is B: Trial of scar. This term specifically refers to the process of attempting a vaginal birth after a previous caesarean section. It involves monitoring the previous cesarean scar for any signs of complications during labor. A: Spontaneous vaginal delivery refers to giving birth vaginally without any previous cesarean section. C: Spontaneous vertex delivery simply describes the position of the baby's head during birth. D: Trial of birth is not a commonly used term in obstetrics and does not specifically relate to VBAC.