What newborn complication does type 1 diabetes mellitus cause?

Correct Answer: C

Rationale: Type 1 diabetes mellitus can cause hypoglycemia in newborns for several reasons. Firstly, during pregnancy, high blood sugar levels in the mother can lead to increased insulin production in the fetus, which can cause low blood sugar levels after birth when the mother's blood sugar is no longer affecting the baby. Secondly, if the mother's blood sugar is not well controlled during pregnancy, the baby may have developed higher insulin levels in response to the high blood sugar, leading to a risk of hypoglycemia after birth. Hyperglycemia (choice A) is not a common newborn complication of type 1 diabetes mellitus because the baby's blood sugar levels are more likely to be low rather than high due to the reasons mentioned above. Umbilical hernia (choice B) is not a common complication of type 1 diabetes mellitus in newborns. Umbilical hernias typically result from a weakness in the abdominal wall at the site of the umbilical cord, and are not directly related to the mother's diabetes. Cyanosis (choice D) is the bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood. While cyanosis can be a serious sign of respiratory or circulatory issues in newborns, it is not a common complication specifically caused by type 1 diabetes mellitus. In conclusion, hypoglycemia is the correct answer because it is a common newborn complication of type 1 diabetes mellitus due to the effects of maternal blood sugar levels during pregnancy on the baby's insulin production and blood sugar regulation.

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.

Correct Answer: B

Rationale: Postpartum hemorrhage is defined as excessive bleeding following childbirth, usually within the first 24 hours. It is a significant cause of maternal mortality and morbidity if not promptly recognized and managed. The correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. A: 250 mL is too low to be considered postpartum hemorrhage. While some blood loss is normal after childbirth, this amount is not typically concerning unless the woman is showing signs of distress or other symptoms. C: 750 mL is closer to the threshold for postpartum hemorrhage, but it is still higher than the generally accepted definition of 500 mL. At 750 mL, the woman would likely be experiencing significant symptoms and would require immediate medical attention. D: 1,000 mL is well above the threshold for postpartum hemorrhage and would indicate a severe and potentially life-threatening situation. At this level of blood loss, the woman would likely be in shock and would require immediate intervention to prevent further complications. In summary, the correct answer is B: 500 mL, as this is the generally accepted threshold for defining postpartum hemorrhage. Any amount of blood loss above this threshold should be taken seriously and prompt medical attention should be sought to ensure the safety and well-being of the mother.