EBCOG Part 1 – 3 months May 2022 – Labour and Delivery – Day 3

1.A 23-year-old has undergone an  induction  of labour  at  41  weeks  +  6  days  in her  first pregnancy.  The  antenatal  care  was  complicated  with  an  admission  to  hospital  with  a small painful antepartum  haemorrhage  at 34  weeks  of  gestation.  The  symptoms  settled spontaneously  and  all  investigations  and  monitoring  were  normal;  her  blood  group  is  AB Rh positive.  Vaginal  prostaglandin  gel  insertion  established  labour  within  3  hours and  the labour  progressed such  that  6  hours  later  the  cervix  was  8  cm  dilated  with  meconiumstained  liquor  with  a  satisfactory  CTG,  and  epidural  anaesthesia  was  instigated.  Three  hours later,  the  fetal head  was  zero -fifth  palpable  abdominally;  the cervix  was  fully dilated;the position  was direct occipito  anterior , 3cm below spines .  with  minimal  caput  and  moulding.  and  a small  amount  of post-examination  vaginal  bleeding  was  noted.   The present CTG is as follows

2. A 32-year-old woman is in labour in her second pregnancy. Her previous delivery was by caesarean section. What is the most consistent indicator of uterine rupture for this woman?

3. Mrs.B is primigravida now 36 weeks of pregnancy with breech presentation . recent scan shows  Flexed breech with  good cardiac activity .Estimated fetal weight is 2450grams.what is advise  you  will give for delivery ?

4. Ms.X , 22 year old is 36 weeks pregnancy,she has concerns about baby’s movements .she works as nursery school teacher and gives history of fever with  rash . Her CTG is as follows. 

What viral infection you  suspect in her ?

5. The variability in this CTG is.

6. whats the base line heart rate in this CTG ?

7.What is the normal range for the term FHR?

8. What is the contraction frequency in this CTG?

9. This CTG was from a primiparous woman in spontaneous labour at full term. She was 3 cm dilated at the time and an epidural catheter had recently been inserted for analgesia, but no other risk factors were identified

10. Ms. Rebecca, para2 Living 2 .Her 1st delivery was forceps delivery & 2nd was cesarean section for  Fetal distress. In her  current pregnancy, what is the most likely measure to reduce the chance of forceps delivery?

11. A woman had an emergency caesarean section for a pathological CTG and pyrexia in labour. She was discharged on postoperative day 4 but re-admitted on day 6 with pyrexia, tachypnoea, tachycardia and hypotension. Haemoglobin is 105 g/l. Septic shock is the main differential diagnosis. Following the Sepsis 6 bundle, along with antibiotics and blood cultures, which other important blood test needs to be taken?

12. All of these are markers of an acute peripartum or intrapartum hypoxic-ischaemic event except:

13. After delivering a baby with a non-reassuring CTG with forceps, you request the umbilical cord blood gas results. The midwife reports a single value of pH 7.06, pCO2 of 7.7kPa and a base excess of -12 mmol/L, along with a venous value of pH 7.3, pCO2 of 5.3kPa and a base excess of -5.6 mmol/L.

Which one of the following statements applies?