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: Fetal exsanguination. This term accurately describes the process of pure fetal blood loss following a ruptured vasa praevia. Exsanguination refers to severe blood loss leading to death. In this context, it specifically denotes the loss of fetal blood due to the rupture of vasa praevia, which can be fatal for the fetus. A: Fetal extra-versation is not a recognized medical term and does not accurately describe the scenario presented in the question. C: Velamentous bleeding refers to a condition where fetal blood vessels are unprotected by the umbilical cord and run through the amniotic membranes, not specifically related to ruptured vasa praevia. D: Fetal hemorrhage is a general term for fetal blood loss and does not specifically address the situation of pure fetal blood loss following a ruptured vasa praevia.

Correct Answer: C

Rationale: The correct answer is C: Wrinkled, peeling skin. Post-maturity syndrome occurs when a pregnancy extends beyond 42 weeks, causing the baby to lose the protective layer of vernix caseosa, leading to dry, peeling skin. Closed eyes and being unusually alert (A) are not specific to post-maturity syndrome. Long, frail fingernails (B) are not a typical characteristic of post-maturity. Excess vernix caseosa (D) is actually a characteristic of a premature baby, not a post-mature one.

Correct Answer: D

Rationale: The correct answer is D because fetal indications for cesarean section typically involve situations where the baby cannot safely be delivered vaginally. Cephalo-pelvic disproportion means the baby's head is too large to pass through the mother's pelvis, necessitating a C-section. Impacted face presentation can result in difficulty during delivery, also requiring a C-section. Locked twins refer to a situation where the babies are unable to move past each other during delivery, further indicating the need for a C-section. Choices A, B, and C include some relevant indications for a C-section, but they do not encompass the full range of fetal indications like choice D does.

Correct Answer: C

Rationale: The correct answer is C because precipitate labor is defined as labor that is concluded in less than three hours. This rapid progression can lead to complications such as increased risk of tearing and fetal distress. Choice A is incorrect because it describes a different condition where the cervix fails to dilate despite good contractions. Choice B is incorrect as it contradicts the definition of precipitate labor. Choice D is incorrect as it describes a scenario where the cervix fails to dilate due to poor uterine contractions, which is not characteristic of precipitate labor. Therefore, choice C is the correct answer based on the definition and characteristics of precipitate labor.