EBCOG Part-1-Management of labour & delivery – DAY2 (SBA)

1.Assisted vaginal birth by vacuum or forceps is used to assist birth for maternal and fetal indications. In Uk what percentage of women give birth by assisted vaginal birth ?

A.5%
B.10%
C.15%
D.20%
E.Both B&C

2.. In nulliparous women , who undergo Assisted vaginal birth is

A.1in 2
B.2in 4
C. 1 in 5
D.1in 3
E.1in 10

3.All are true regarding Assisted operative vaginal delivery except

A. when performed correctly by appropriately trained personnel, result in a safe outcome for the woman and baby.
B. Women who achieve an assisted vaginal birth rather than have a caesarean birth with their first child are far more likely to have an complicated vaginal birth in subsequent pregnancies,
C. caesarean birth late in the second stage of labour can be very challenging and result in significant maternal and perinatal morbidity.
D. the Montgomery ruling has emphasised the importance of informed consent
E. There has been a rise in the rate of caesarean births in the second stage of labour

4.Mrs, X is primigravida referred from midwifery unit .She is been fully dilated for 4hrs , she is on ePidural analgesia . Meconium stained liquor .CTG showing deep variable decelerations .persistent occipito transverse .Consultant decides for rotational forceps delivery .

A.she can deliver in room as she is on epidural analgesia but need written consent
B. She has to be taken to operation theatre for trial of forceps and verbal consent is necessary
C. It’s risky to do rotational forceps better to do cesarean section with written consent
D. She has to be taken to operation theatre for rotational forceps delivery and written informed consent is necessary
E. Wait for 1hr

5.Ms.Lisa, has pushing at full dilatation for over 2 hours now with no obvious progress even with syntocinon infusion.Decided for vacuum delivery .she delivered with third pull ,two times vacuum pulled off .Mother s worried about.The swelling on baby’s head which is boggy soft pitting , crossing suture lines ,but baby is absolutely fine active , breastfeeding .no creptus moted .Image is enclosed .

This swelling is

A.caput succedaneum
B.cephalhematoma
C.subgaleal Haemorrhage
D. Extradural Haemorrhage
E.none of the above

6.Which one of the following factors (NOT?) decreases the likelihood of a successful vaginal birth after caesarean section (VBAC)?

A. Epidural labour analgesia
B. Maleinfant
C. Non-whiteethnicity
D. Previous caesarean section for dystocia
E. VBAC at or after 41 weeks of gestation

7.A26-year-old woman attends antenatal clinic at 28 weeks’ gestation.She has had one previous pregnancy 2 years ago, which ended in a Caesarean section after failure to progress beyond 6 cm cervical dilatation. Her current body mass index is 30 kg/m2. She would like know the likelihood of having a successful vaginal delivery should she try for one this time.What is the likelihood of her achieving a vaginal birth after having had a Caesarean section?

A. 38%
B. 40%
C 50%
D 72%
E 82%

8. A 40-year-old woman had one previous normal vaginal delivery at the age of 17 years and one maternally requested a Caesarean section at the age of 38 years. She is currently 28 weeks pregnant. She is not sure if she wants to try for a vaginal delivery or have an elective Caesarean section. She wants to know what her chance of death is if she has a Caesarean section.What are the chances of this patient dying if she has a Caesarean section’?

A 1/100,000
B 5/100,000
C 11/100,000
D 13/100,000
E 15/100,000

9.A 35-year-old woman had an elective Caesarean section 4 years ago for a breech presentation. She is now 36 weeks pregnant in her second pregnancy. She would like to try for a vaginal birth after Caesarean section (VBAC).She wants to know what risk her baby has of developing hypoxic ischaemic encephalopathy or brain damage after a VBAC.What is the risk of the baby developing hypoxic ischaemic encephalopathy or brain damage after a VBAC?

A 2/10,000
B 4/10,000
C 8/10,000
D10/10,000
E 15/10,000

10.A 34-year-old primigravid woman presents in labour, having been pushing for 75 minutes. You are asked to review whether she is suitable for an operative vaginal delivery. Which of the following is correct?

A. Epidural with oxytocin in the second stage of labour increases the incidence of non-rotational forceps delivery in primiparous women
B. Fetal alloimmune thrombocytopenia is a relative contraindication to operative vaginal delivery
C. Instrumental delivery is contraindicated if any part of the fetal head is palpable Abdominally
D. Maternal BMI over 30 is not associated with a higher rate of failed instrumental delivery until BMI is over 40
E. Ventouse delivery is safe beyond 35 weeks of gestation

11.Following a prolonged second stage of labour, a woman is taken to theatre for a trial of forceps delivery. Examination in theatre reveals the fetal head to be one-fifth palpable per abdomen. On vaginal examination, the station of the fetal head is +1.How would the forceps delivery be classified?

A. High
B. Unclassifiable
C. Low
D. Mid
E. Outlet

12.A 36-year-old woman had a normal vaginal delivery when she was 20 years old (for maternal request). She is now 30 weeks ’pregnant and wants a repeat elective caesarean section. What are her chances of death if she has a planned cesarean section at 39 weeks of gestation?

A.15/100,000
B.13/100,000
C.11/100,000
D.5/100,000
E.1/100,000

13. What is the single best predictor of a successful vaginal birth after a caesarean section?

A. Gestation when in labour
B. History of a previous vaginal birth
C. Maternal age
D. Scar thickness measured by ultrasound
E. Type of caesarean section

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EBCOG Part-1-Management of labour & delivery – DAY2 (SBA)

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