My MFM

Question 1

The leading risk factor for shoulder
Dystocia

Answer 1

Maternal diabetes
(the risk of shoulder dystocia doubles across all birthweight categories and infants of diabetic mothers with further increases in instrument assisted forceps or vacuum deliveries.

Diabetes increases the overall risk of shoulder by 70% 

Question 2

What type of delivery minimizes perinatal risks of macrosomia?

Answer 2

Cesarean delivery.

Perinatal risk of macrosomia include necessitation ofinstrumentation or abdominal delivery. Due to Frank cephalopelvic disproportion.

Associated birth trauma may lead to fracture of clavicle, brachial, plexus injury, neurologic damage, or infant death. 

Question 3

If it’s born to mothers with elevated glucose concentrations at risk of what?

Answer 3

Macrosomia and glucose intolerance and diabetes later in life.

Reduced beta cell function is one of the mechanisms underlying these metabolic changes.

Question 4

Increasing the risk of uterine rupture

Answer 4

Prior preterm cesarean
Single layer, uterine closure.
Short, Interpregnancy, interval, less than 18 months
Multiple prior C-section deliveries
Induction and augmentation of labor
With (2.5%)or without prostaglandins (0.77%)

Key: the risk of uterine rupture was lowest amongst the women who delivered following spontaneous labor
(0.52%)

The main risk of vaginal birth after cesarean is uterine rupture with incisors of 0.5 to 1%

Question 5

Newborn with perinatal, depression typically present, with what symptoms

Answer 5

Slow respirations but in reactions.
Bradycardia.
Pallor with cyanosis 

Question 6

Twins are at risk for (post Nataly)

Answer 6

(Metabolic derangements)
Higher incidence of insulin resistance.
Glucose intolerance.
Type two diabetes.

There are no differences in the incident of tattoo, diabetes between monozygotic and dizygotic twins

Question 7

Explain vasa previa and its risk associations?

Answer 7

The prevalence is much higher and pregnancies conceived by assisted reproductive technologies.
Pregnancy associated with presented previa.
Bilobed placentas.
Multiple gestations

vasa previa is a condition that arises when fetal blood vessels implant into the placenta in a way that covers the internal os of the uterus.

Affected women are at risk for a rupture of vasa previa and significant fetal blood loss upon spontaneous or artificial rupture of membranes .

Question 8

What’s the difference between a cephalohematoma and a capital secundum?

Answer 8

A cephalohematoma is confined by the suture lines.

A caput secundum crosses the suture lines.

Subgaleal hemorrhage - bleeding can extend from the nape of the neck to orbit, the ridges anterior into the temporal fascia laterally it is estimated that some gel space has a potential to accumulate up to 260 mL of blood