Which one of the following signs is indicative of possible shoulder dystocia during delivery?

Correct Answer: B

Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery. A: Failure of internal rotation of the head is not specific to shoulder dystocia. C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation. D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.

Correct Answer: B

Rationale: The correct answer is B: A surgical procedure in which the cartilage of the pubic symphysis is divided. Pubiotomy involves cutting the pubic symphysis cartilage to widen the pelvic outlet during difficult childbirth. This procedure helps facilitate labor by increasing the pelvic diameter. Choices A, C, and D are incorrect because they do not accurately describe pubiotomy. Choice A refers to accessing the lower uterine segment, choice C involves ligating pubic bones for cancer, and choice D pertains to perineal tissue dissection during labor, which are unrelated to pubiotomy.

Correct Answer: B

Rationale: The correct answer is B: Conduction. Conduction is the transfer of heat through direct contact. By keeping the neonatal unit warm and wrapping neonates in warm blankets, heat loss through direct contact with surfaces is minimized. Convection involves heat transfer through air or fluid movement, not relevant in this scenario. Evaporation is the process of heat loss through moisture evaporation from the skin, not applicable here. Radiation is heat transfer through electromagnetic waves, which can be prevented by warm wrapping but not the primary focus in this context.

Correct Answer: D

Rationale: The correct answer is D: Fetal macrosomia. Fetal macrosomia, which refers to a baby being significantly larger than average, is an inorganic risk factor for birth injuries because it can lead to difficult delivery and increase the risk of birth trauma such as shoulder dystocia. Maternal short stature (A) is a biological risk factor, not inorganic. Prenatal oligohydramnios (B) refers to low levels of amniotic fluid and is a maternal condition, not an inorganic factor. External cephalic version (C) is a procedure to turn a breech baby and is not a risk factor for birth injuries.

Correct Answer: A

Rationale: The correct answer is A (1000-500 gm) because extremely low birth weight babies are typically defined as those weighing less than 1000 grams (1kg) at birth. This range specifically includes weights below 1000 grams, making it the most accurate choice. Choice B (500-1500 gm) is incorrect because it includes weights above the threshold for extremely low birth weight (1000 gm). Choice C (1001-1500 gm) is incorrect because it excludes babies weighing less than 1000 gm, which are considered extremely low birth weight. Choice D (1500-2000 gm) is also incorrect as it includes weights above the range for extremely low birth weight babies.

Correct Answer: B

Rationale: The correct answer is B: Face presentation. Vaginal delivery is possible in face presentation as the fetus is in a position where the face is presenting first, allowing for delivery. In this presentation, the chin is usually tucked onto the chest, making it easier for the baby's head to pass through the birth canal. A: Brow presentation is incorrect because it indicates the baby's head is extended slightly, making it more difficult for vaginal delivery. C: Shoulder presentation is incorrect as it can lead to a shoulder dystocia, making vaginal delivery dangerous and difficult. D: Unstable lie is incorrect because it refers to the baby being in a transverse position, making vaginal delivery impossible without intervention.

Correct Answer: A

Rationale: The correct answer is A because monozygotic twins, also known as identical twins, develop from a single fertilized egg and share the same genetic material. This results in them always being of the same sex. Choice B is incorrect because fingerprint patterns are not solely determined by genetics. Choice C is incorrect because monozygotic twins will have the same blood group since they share the same DNA. Choice D is incorrect because superfetation, the fertilization of multiple eggs at different times during the same pregnancy, is not common in monozygotic twins.

Correct Answer: A

Rationale: The correct answer is A: External cephalic version. This procedure involves manually manipulating the baby from a breech position to a head-down position. It is recommended as a safe and effective way to manage breech presentations, reducing the need for a cesarean section. Immediate cesarean (B) is not always necessary and should be reserved for specific medical reasons. Pelvic X-ray (C) is not routinely recommended for managing breech presentations. Induction of labor (D) is not the primary strategy for managing breech presentations, as it does not address the positioning of the baby.

Correct Answer: B

Rationale: The correct answer is B: Presence of the Bandl's ring. This is indicative of an abnormal labor pattern as it may suggest a uterine rupture, which is a serious complication. Bandl's ring is a constriction ring formed between the upper and lower uterine segments due to excessive uterine contractions. It can lead to fetal distress and necessitate immediate medical intervention. A: Presence of the retraction ring is a normal phenomenon during labor, marking the boundary between the lower and upper uterine segments. C: Cervical canal short and thin can be a normal variation in labor and does not necessarily indicate an abnormal pattern. D: Vagina being warm and moist is a common physiological response during labor and does not provide information on the progress or abnormality of labor.