What is a fetal complication of vacuum extractor use?

Correct Answer: A

Rationale: Vacuum extractors are commonly used during vaginal deliveries to assist with the extraction of the baby. One potential complication of vacuum extractor use is a cephalohematoma, which is the collection of blood between the skull bone and its fibrous covering. This can occur due to the pressure exerted on the baby's head during the extraction process, leading to a localized swelling. Choice B, face presentation, is not a fetal complication of vacuum extractor use. Face presentation refers to the position of the baby's head during delivery, where the face presents first instead of the top of the head. This is a different issue unrelated to vacuum extraction. Choice C, fetal growth restriction, is also not a fetal complication of vacuum extractor use. Fetal growth restriction occurs when a baby does not grow at the expected rate inside the womb, leading to a smaller than average size. This is a result of various factors such as maternal health, placental issues, or genetic factors, rather than vacuum extraction. Choice D, scalp fracture, is not a common complication of vacuum extractor use. While it is possible for a scalp fracture to occur during a difficult delivery, it is not specific to vacuum extraction. Scalp fractures are more commonly associated with the use of forceps or other instruments during delivery, rather than vacuum extraction. In summary, the correct answer is A (cephalohematoma) because it is a recognized fetal complication of vacuum extractor use. Face presentation (B), fetal growth restriction (C), and scalp fracture (D) are not directly related to vacuum extraction and do not typically result from its use.

Correct Answer: A

Rationale: Category III FHR tracings indicate abnormal fetal heart rate patterns that require immediate evaluation and intervention. In this case, delivery should occur within 15 minutes to prevent potential adverse outcomes for the fetus. Choice B (30 minutes) is incorrect because waiting an additional 15 minutes could lead to further deterioration of the fetal condition, increasing the risk of hypoxic injury or even fetal demise. Choice C (45 minutes) is also incorrect as it exceeds the recommended timeframe for delivery with a Category III FHR tracing. Waiting this long could result in significant harm to the fetus due to inadequate oxygenation. Choice D (60 minutes) is the furthest from the correct answer and poses the highest risk to the fetus. Delaying delivery for an hour with a Category III FHR tracing could have catastrophic consequences, including irreversible brain damage or stillbirth. In summary, the correct answer is A (15 minutes) because prompt delivery is crucial in cases of Category III FHR tracings to optimize fetal outcomes and minimize the risk of complications.

Correct Answer: C

Rationale: Prolonged second stage labor refers to the period of time from complete cervical dilation to the birth of the baby. One of the risks associated with prolonged second stage labor is an increased risk of fetal distress (Choice C). This is because when the baby remains in the birth canal for an extended period of time, it can lead to decreased oxygen supply and potential complications for the baby, such as meconium aspiration or fetal heart rate abnormalities. Choice A, decreased risk of instrumental delivery, is incorrect because prolonged second stage labor can actually increase the likelihood of needing instruments such as forceps or vacuum extraction to assist with the delivery due to maternal exhaustion or fetal distress. Choice B, decreased risk of cesarean birth, is also incorrect. Prolonged second stage labor can increase the risk of cesarean birth if there are concerns about the baby's well-being or if the labor is not progressing despite interventions. Choice D, increased risk of rapid delivery, is incorrect as prolonged second stage labor is characterized by a slow progression of labor rather than a rapid delivery. Rapid delivery is more often associated with precipitous labor, which is when the baby is born within a very short period of time, typically less than three hours from the onset of labor. In conclusion, the correct answer is C because prolonged second stage labor can increase the risk of fetal distress due to decreased oxygen supply and potential complications for the baby.

Correct Answer: C

Rationale: Placenta accreta is a serious pregnancy complication where the placenta attaches too deeply into the uterine wall. The most common cause of placenta accreta is a previous cesarean birth (Choice C). This is because during a cesarean section, the placenta can grow into the scar tissue from the previous surgery, making it difficult to detach during delivery. This increases the risk of placenta accreta in subsequent pregnancies. Choice A, malnutrition, is not a common cause of placenta accreta. While a poor diet can impact pregnancy outcomes, it is not directly linked to the development of placenta accreta. Choice B, smoking, is also not a common cause of placenta accreta. Smoking during pregnancy can lead to a variety of complications, but it is not a known risk factor for placenta accreta specifically. Choice D, obesity, is not the most common cause of placenta accreta, although it can be a risk factor. Obesity can lead to various pregnancy complications, but it is not as directly linked to placenta accreta as a previous cesarean birth. In conclusion, the most common cause of placenta accreta is a previous cesarean birth. It is important for healthcare providers to be aware of this risk factor in order to properly monitor and manage pregnancies at risk for placenta accreta.

Correct Answer: A

Rationale: Decreased capillary refill and diminished peripheral pulses are indicative of altered perfusion. Perfusion refers to the circulation of blood through tissues, providing them with oxygen and nutrients while removing waste products. When capillary refill is decreased, it means that blood is not flowing properly to the tissues, resulting in a delay in the return of color to the skin after pressure is applied. Diminished peripheral pulses also suggest inadequate blood flow to the extremities, which can lead to tissue damage and impaired function. Choice B, alteration in liver function, is incorrect because liver function does not directly affect capillary refill or peripheral pulses. Liver function is primarily related to metabolism, detoxification, and bile production. Choice C, alteration in kidney function, is also incorrect as kidney function is primarily related to filtration of blood and regulation of electrolytes and fluid balance. While kidney dysfunction can lead to fluid retention and altered blood volume, it does not directly affect capillary refill or peripheral pulses. Choice D, alteration in uterine function, is unrelated to the signs of decreased capillary refill and diminished peripheral pulses. Uterine function is primarily related to menstruation, pregnancy, and labor, and does not have a direct impact on blood flow to the extremities.