What is a sign of intrauterine fetal demise?

Correct Answer: C

Rationale: Intrauterine fetal demise refers to the death of a fetus inside the uterus before birth. One of the signs of intrauterine fetal demise is decreased or absent fetal movement. This occurs because the fetus is no longer alive and therefore cannot move. Fetal movement is a reassuring sign of fetal well-being, so a lack of movement is concerning. Increased fetal heart rate (Choice A) is not a sign of intrauterine fetal demise. In fact, a rapid fetal heart rate can indicate fetal distress or other issues, but it is not typically associated with fetal demise. Vaginal bleeding (Choice B) can be a sign of various complications during pregnancy, such as placental abruption or placenta previa, but it is not a specific sign of intrauterine fetal demise. Macrosomia (Choice D) refers to a baby who is significantly larger than average at birth. This is not a sign of intrauterine fetal demise but rather a risk factor for complications during delivery, such as shoulder dystocia. In summary, the correct answer is C because decreased or absent fetal movement is a significant sign of intrauterine fetal demise, while the other choices are not specific indicators of this condition.

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: D

Rationale: Vasa previa is the condition where the umbilical cord vessels cross the cervix. This can be a dangerous situation during pregnancy and delivery because the vessels are not protected by Wharton's jelly or the umbilical cord itself, making them vulnerable to rupture and fetal hemorrhage if the membranes rupture before delivery. This condition is a medical emergency that requires immediate intervention to prevent harm to the baby. Placenta previa, on the other hand, is a condition where the placenta implants low in the uterus and covers part or all of the cervix. This can cause painless bleeding in the third trimester and can lead to complications during delivery, but it is not specifically related to the umbilical cord vessels crossing the cervix. Placenta cervix is not a recognized medical term and does not describe any specific condition related to the umbilical cord or placenta. Velamentous insertion is a condition where the umbilical cord inserts into the fetal membranes rather than directly into the placenta. This can also lead to complications during delivery, but it does not involve the umbilical cord vessels crossing the cervix. In summary, vasa previa is the correct answer because it specifically describes the condition where the umbilical cord vessels cross the cervix, putting the baby at risk for serious complications. Placenta previa, placenta cervix, and velamentous insertion are incorrect because they do not involve this specific anatomical situation.

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.