What is a complication of footling breech?

Correct Answer: A

Rationale: A footling breech presentation is when the baby's feet are positioned to come out first during delivery. One of the complications of this presentation is a prolapsed cord. This occurs when the umbilical cord slips through the cervix before the baby, leading to compression and potential cutting off of the baby's oxygen supply. This is a serious emergency situation that requires immediate intervention to prevent harm to the baby. Oligohydramnios, on the other hand, refers to a low level of amniotic fluid surrounding the baby. While this can lead to complications during pregnancy and delivery, it is not specifically associated with a footling breech presentation. A low biophysical profile score is a test used to assess the baby's health during pregnancy. It evaluates factors such as fetal movement, muscle tone, breathing movements, and the amount of amniotic fluid. While a footling breech presentation may impact the biophysical profile score, it is not a direct complication of this presentation. Meconium-stained fluid occurs when the baby passes their first bowel movement (meconium) while still in the womb, leading to discoloration of the amniotic fluid. While this can be a concern during delivery, it is not a specific complication associated with a footling breech presentation. In conclusion, a prolapsed cord is the correct answer as it is a known complication of footling breech presentation, posing a serious risk to the baby's oxygen supply and requiring immediate medical attention.

Correct Answer: C

Rationale: Labor dystocia is a common reason for cesarean birth because it refers to a difficult or prolonged labor, which can occur due to various reasons such as abnormal positioning of the baby, inadequate contractions, or the baby being too large to pass through the birth canal. In cases of labor dystocia, a cesarean birth may be necessary to safely deliver the baby and prevent complications for both the laboring person and the baby. Choice A, cephalic presentation, is not a common reason for cesarean birth because it actually refers to the baby being in the head-down position, which is the optimal position for vaginal delivery. While a baby in a breech or transverse position may necessitate a cesarean birth, a cephalic presentation is not a reason for cesarean birth. Choice B, laboring person's BMI of 23, is also not a common reason for cesarean birth. While obesity can increase the risk of complications during pregnancy and delivery, a BMI of 23 is within the normal range and would not typically be a reason for cesarean birth on its own. Choice D, lack of adequate pain control, is not a common reason for cesarean birth. While pain management is an important aspect of labor and delivery, the decision to perform a cesarean birth is typically based on medical reasons related to the safety of the laboring person or the baby, rather than the level of pain control.

Correct Answer: C

Rationale: Velamentous insertion is the correct answer because it is a rare condition where the umbilical cord vessels branch before reaching the placenta and then insert into the fetal membranes instead of directly into the placental tissue. This can lead to potential complications such as fetal vessels being compressed during labor, which can result in fetal distress and even fetal death. Placenta previa (choice A) is a condition where the placenta partially or completely covers the cervix, leading to potential bleeding during the third trimester of pregnancy. This is not related to the branching of umbilical cord vessels prior to insertion into the placenta. Placenta cervix (choice B) is not a recognized medical condition. It seems to be a combination of placenta previa and cervix, but it is not a valid term in obstetrics. Vasa previa (choice D) is a condition where fetal blood vessels run through the amniotic membranes over the cervix and can be at risk of rupture if the water breaks. This is different from velamentous insertion because it involves the location of the umbilical cord vessels relative to the cervix and amniotic membranes, not the branching of vessels before insertion into the placenta.

Correct Answer: A

Rationale: Uterine rupture is a serious obstetric complication where the uterine wall tears during pregnancy or labor. DIC (Disseminated Intravascular Coagulation) is a known complication of uterine rupture. When the uterus ruptures, it can cause massive bleeding, leading to a systemic response that triggers DIC. This is because the release of tissue factor from the injured uterus activates the coagulation cascade, which can result in both clotting and bleeding abnormalities throughout the body. Nuchal cord, on the other hand, is when the umbilical cord becomes wrapped around the baby's neck. While this can cause fetal distress during labor, it is not directly related to uterine rupture. Polyhydramnios is a condition characterized by an excessive amount of amniotic fluid surrounding the baby in the uterus. While polyhydramnios can increase the risk of uterine rupture due to the increased pressure on the uterine wall, it is not a direct complication of uterine rupture. Oligohydramnios, on the other hand, is a condition characterized by too little amniotic fluid surrounding the baby in the uterus. This can lead to complications such as fetal growth restriction and umbilical cord compression, but it is not directly related to uterine rupture. In summary, DIC is the correct answer because it is a known complication of uterine rupture due to the significant bleeding that can occur when the uterus tears.

Correct Answer: D

Rationale: Using forceps or a vacuum to assist delivery is the correct intervention for managing failure to descend during labor. When the baby fails to descend through the birth canal despite adequate pushing efforts, it can lead to complications for both the mother and the baby. Forceps and vacuum extraction are tools used by healthcare providers to help guide the baby through the birth canal and facilitate delivery. Administering pain medication, choice A, may provide relief to the mother during labor, but it does not directly address the issue of failure to descend. Pain medication will not help the baby descend through the birth canal. Allowing the patient to rest, choice B, may be beneficial in some cases to allow the mother to regain energy and continue pushing effectively. However, if there is a true failure to descend, simply resting will not resolve the issue and may lead to further complications. Continuing to push for an extended period of time, choice C, can be dangerous for both the mother and the baby. Prolonged pushing without progress can lead to exhaustion for the mother and distress for the baby. It is important to recognize when additional intervention is necessary to ensure a safe delivery. In conclusion, using forceps or a vacuum to assist delivery is the most appropriate intervention for managing failure to descend during labor as it directly addresses the issue and helps guide the baby through the birth canal safely.