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L3 (1ST BMEX) > OB 1 > Flashcards

OB 1 Flashcards

1
Q

Which of the following will necessitate admission of a pregnant woman?

A. Production of bloody vaginal discharge
B. Uterine contraction every 2x/hour mild
C. Watery vaginal discharges
D. Bipedal edema

A

C. Watery vaginal discharges

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2
Q

The bony part of the pelvis and maternal soft parts represent this determinant labor outcome

A. Passenger Fetus
B. Powers
C. Parity
D. Passage

A

D. Passage

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3
Q

The cardinal movements of labor occur during this division

A. Latent phase
B. Acceleration phase
C. Dilatation division
D. Pelvic division

A

D. Pelvic division

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4
Q

Labor is confirmed under the following circumstances

A. No uterine contractions, cervix 2cm, 50% effaced
B. Cervix 1cm, uneffaced, irregularly occurring contraction
C. Intermittent contraction q30 min, cervix 3cm, 50% effaced
D. Bloody show, mild contractions, cervix 1cm, uneffaced

A

C. Intermittent contraction q30 min, cervix 3cm, 50% effaced

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5
Q

Which of the following is an exclusion in the indication of doing vaginal examination?

A. History of vaginal bleeding episodes starting 5th month of pregnancy
B. Presence of bloody mucoid discharges upon admission
C. History of watery vaginal discharge 1 hour before admission
D. Induction of labor for 2 hours already

A

A. History of vaginal bleeding episodes starting 5th month of pregnancy

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6
Q

The Friedman’s partogram enables us to detect the risk of this type of disorder during the active phase

A. Prolonged disorder
B. Protraction disorder
C. Arrest disorder
D. Failure disorder

A

B. Protraction disorder

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7
Q

This cardinal movement converts occipitofrontal to suboccipitobregmatic diameter

A. Descent
B. Flexion
C. Internal rotation
D. External rotation

A

B. Flexion

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8
Q

What is the best method to monitor progress of labor in a low-risk patient?

A. Do vaginal exam every 1-2 hours
B. Plot the partogram
C. Put the patient on EFM
D. Feel for contractions by putting hands on patient’s abdomen

A

B. Plot the partogram

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9
Q

Which of the following is the most valid indication in performing episiotomy?

A. It is easier to repair a clean incision than a laceration
B. Doing the procedure hastens the second stage of labor
C. Delivery by instrumentation is contemplated
D. Episiotomy will preserve the integrity of the perineum

A

C. Delivery by instrumentation is contemplated

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10
Q

A G1P0 patient in early labor. Cervix is 3cm on internal evaluation, asked if she can be given food because she is famished. Evaluation shows no abnormal findings located. EFW 3.5kg. No comorbid history. The best response is

A. give soft diet for energy
B. give her liquid diet
C. start her on antacids
D. start your IVF infusion

A

D. start your IVF infusion

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11
Q

Which of the following necessitates intervention in the 3rd stage of labor?

A. Baby delivered 10 mins with no signs of placental separation
B. Minimal bleeding noted, noted cord lengthening ceased 40 mins postpartum
C. Uterus globular and rose up to the abdomen 10 minutes postpartum
D. Cord slackened with gentle traction 20 minutes postpartum

A

B. Minimal bleeding noted, noted cord lengthening ceased 40 mins postpartum

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12
Q

At what point in the postpartum will the descent and dilatation curve cross each other under normal uneventful progressive labor?

A. 5-6 cm
B. 6-7 cm
C. 7-8 cm
D. 8-9 cm

A

D. 8-9 cm

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13
Q

Which of the following is the best means in determining the AOG and EDC in a patient who has lactation amenorrhea for 6 months postpartum but upon consult at the OPD was found to have uterine enlarged to 4 months’ size with positive Doppler and recent appreciation of quickening?

A. Use LMP as basis
B. Request for ultrasonography
C. Rely on fundic height measurement
D. Estimated based on appreciation of fetal movement

A

B. Request for ultrasonography

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14
Q

Only one of the following is not contributing to the descent of fetus during labor

A. Bearing down efforts of the mother
B. Pressure of the amniotic fluid
C. Resistance of the pelvic floor
D. Straightening of the fetal body

A

C. Resistance of the pelvic floor

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15
Q

A patient consults for a positive pregnancy test. She claimed to have regular menses although she only had a 3-day spotting in her last period which was March 23, 2022. Her period though was last February 25, 2022 had a normal 3-day flow like her usual. When is her EDC?

A. December 30, 2022
B. January 2, 2023
C. December 2, 2022
D. November 30, 2022

A

C. December 2, 2022

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16
Q

A G3P2 patient AOG term, has been admitted for 10 hours already due to mild contractions, cervix 2cm uneffaced. Recent evaluation showed 3cm 50% effaced cervix but mild contractions. The best management:

A. Expectant waiting
B. Send the patient home and come back when the contractions are painful
C. Start potentiating labor with oxytocics
D. Sedate the patient

A

C. Start potentiating labor with oxytocics

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17
Q

The AOG of a patient admitted August 15, 2022 with LMP January 13, 2022 is:

A

30.5

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18
Q

JS, 35 yo was admitted due to painless moderate vomiting. She is currently 25 weeks pregnant. She had an ectopic pregnancy a year before this pregnancy. Her first delivery was 2 months before date due to severe preeclampsia but baby survived. This was followed by a full term delivery to repeat CS baby alive. With her first husband, she had pregnancy which turned out to be H. mole so she underwent D&C. What is her complete OB score?

A. G4P2 (1112)
B. G4P2 (1122)
C. G5P2 (1122)
D. G5P3 (1113)

A

C. G5P2 (1122)

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19
Q

Which of the following is the most rational management in a patient who is G3P2 in labor has been in 6cm dilatation, 70% effacement, -1 station for 2 hrs with mild to moderate contractions occurring 1 in 20 minutes lasting 30 seconds?

A. Watchful waiting
B. Start IV run on 30 gtts/min
C. Consider C-section in 1 hour
D. Start IVF and potentiate contractions with oxytocin

A

D. Start IVF and potentiate contractions with oxytocin

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20
Q

Which of the following measures is aimed to control expulsion of the fetal head thereby preventing perineal lacerations?

A. Crede’s maneuver
B. Putting patient assume extreme lithotomy position
C. Good perineal support
D. Modified Ritgen maneuver

A

D. Modified Ritgen maneuver

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21
Q

Bea, a full term, G4P3 is admitted with an 8-cm cervical dilation, LOT, BOW intact. She would benefit best with?

A. Trial of labor
B. Forceps delivery
C. X-ray pelvimetry
D. Cesarean section

A

A. Trial of labor

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22
Q

The fundamental clinical change during the first stage of labor is

A. descent
B. cervical dilatation
C. internal rotation
D. engagement

A

B. cervical dilatation

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23
Q

The head is presumed to be engaged

A. When the caput succedaneum is almost visible in the introitus
B. When the lowermost portion of fetal head is at the level of ischial spines
C. When there are late decelerations on CTG
D. All of the above

A

B. When the lowermost portion of fetal head is at the level of ischial spines

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24
Q

Increased rate of fetal descent is ordinarily observed during the

A. Latent phase
B. Acceleration phase
C. Phase of maximum slope
D. Deceleration phase

A

C. Phase of maximum slope

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25
Q

The fetal heart rates are check _______ of a contraction to identify pathological slowing

A. at the beginning
B. during the peak
C. at the end and immediately after
D. AOTA

A

C. at the end and immediately after

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26
Q

The cardinal movements of labor and delivery involve a certain sequence of events that occur in an orderly manner. Which of the following sequences is correct?

A. Descent / Internal rotation / Flexion
B. Engagement / Descent / Internal rotation
C. Flexion / Extension / Internal rotation
D. Engagement / Descent / Flexion

A

D. Engagement / Descent / Flexion

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27
Q

What phase does uterine contractions, cervical dilation, fetal and placental expulsion occur?

A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4

A

C. Phase 3

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28
Q

Sedation and conduction anesthesia can arrest this division

A. Preparatory
B. Dilatational
C. Pelvic
D. Latent

A

A. Preparatory

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29
Q

Cervical dilatation proceeds at its most rapid rate in this division

A. Preparatory
B. Latent
C. Dilatational
D. Pelvic

A

C. Dilatational

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30
Q

Most important component of labor

A. Engagement
B. Descent
C. Flexion
D. Internal rotation

A

B. Descent

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31
Q

Which of the following cardinal movements of labor is completed by the time the head reaches the pelvic floor or shortly after the head reaches the pelvic floor?

A. Flexion
B. Internal rotation
C. Extension
D. External rotation

A

B. Internal rotation

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32
Q

Jinky, a 24-year-old G1 on her 38 weeks’ age of gestation, comes to you at the emergency department due to watery vaginal discharge. On examination, uterine contractions were noted at 3/10 minutes’ interval, lasting 40 seconds with strong intensity. On internal examination, cervix was 9cm dilated, 100% effaced, station 0, with ruptured bag of water. Descent begins in the stage of active dilatation, commencing at which cervical dilatation among nulliparas?

A. 5cm
B. 6cm
C. 7cm
D. 9cm

A

C. 7cm

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33
Q

Monica, a 41-year-old G1 on her 41 3/7 weeks’ age of gestation has been at 7-cm cervical dilation for 2 hours. You as a student clerk was tasked to monitor fetal heart rate and report it to your resident in charge. Monitoring should be done using

A. continuous electronic monitoring with evaluation of tracing every 5 minutes
B. continuous electronic monitoring with evaluation of tracing every 15 minutes
C. fetal heart auscultation immediately after a contraction every 5 minutes
D. fetal heart auscultation immediately after a contraction every 30 minutes

A

B. continuous electronic monitoring with evaluation of tracing every 15 minutes

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34
Q

Saoirse, a 21-year-old G1 on her 37 4/7 weeks’ age of gestation, comes to the emergency department due to watery vaginal discharge. Which of the following recommendations warrants this patient to receive antibiotics?

A. Rupture of membranes greater than 12 hours
B. Intrapartum temperature >100.40F
C. Foul discharge
D. Maternal bradycardia

A

B. Intrapartum temperature >100.40F

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35
Q

Esther, an 18-year-old G1 on her 36 weeks AOG, came in for her prenatal visit. On Leopold’s maneuver, L1 was hard and round; L2 on one side was hard, with a resistant structure, on the other side, fetal small parts were felt; L3 was round and nodular. What is the fetal presentation?

A. Cephalic
B. Breech
C. Transverse
D. Oblique

A

B. Breech

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36
Q

Marina, 28 years old, G3P2 (2002) on her 38 weeks of gestation, comes to the ER due to labor pains. On examination, cervix was fully dilated. On palpation, the anterior fontanel was felt. Which of the following describes the portion of the fetal body in closest proximity to the birth canal?

A. Fetal presentation
B. Fetal lie
C. Fetal position
D. Fetal attitude

A

A. Fetal presentation

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37
Q

Which of the following is the smallest head diameter that allows labor to progress?

A. Suboccipitofrontal diameter
B. Suboccipitobregmatic diameter
C. Temporofrontal diameter
D. Biparietal diameter

A

B. Suboccipitobregmatic diameter

38
Q

Which of the following would lead to occiput posterior presentations?

A. Head rotates posterior to the hollow of the sacrum
B. Head rotates anteriorly to the symphysis pubis
C. Occiput rotates from transverse position
D. Sagittal suture is close to the symphysis

A

A. Head rotates posterior to the hollow of the sacrum

39
Q

Nicola, a 20-year-old G1, came in due to uterine contractions lasting 1/10 mins, lasting 20 seconds in mild intensity. Prolonged latent phase in this patient was defined as exceeding

A. 14 hours
B. 16 hours
C. 18 hours
D. 20 hours

A

D. 20 hours

40
Q

Which of the following refers to changes in the bony fetal had shape as a result of external compressive forces?

A. Caput edema
B. Caput succedaneum
C. Molding
D. Cephalhematoma

A

C. Molding

41
Q

Which of the following maneuvers determine the fetal presentation, as one hand grasps the lower portion of the maternal abdomen just above the symphysis pubis?

A. Pelvic grip
B. Pawlick’s grip
C. Fundal grip
D. Umbilical grip

A

B. Pawlick’s grip

42
Q

Direct myometrial pressure of the fundus upon the breech with contractions brings forth this

A. Engagement
B. Descent
C. Flexion
D. Internal rotation

A

B. Descent

43
Q

A 28-year-old primigravid at term presents in labor. She is already bearing down. On examination, the fetal head is already visible at the introitus. What is the fetal station?

A. -5
B. -2
C. +2
D. +5

A

D. +5

44
Q

This refers to the lateral deflection of the sagittal suture towards the sacral promontory

A. Normal asynclitism
B. Oblique asynclitism
C. Anterior asynclitism
D. Posterior asynclitism

A

C. Anterior asynclitism

45
Q

Active management of the third stage of labor includes all of the following, except

A. Controlled cord traction
B. Oxytocin 10 units IM
C. Uterine massage
D. Methergine deep IM

A

D. Methergine deep IM

46
Q

A delay in umbilical cord clamping for up to 60 seconds gives these benefits, except

A. Increase total body iron stores
B. Expand blood volume
C. Decrease anemia incidence
D. Reduce hypothermia

A

D. Reduce hypothermia

47
Q

True onset of labor is defined by

A. bloody show
B. uterine contractions
C. watery vaginal discharge
D. cervical dilatation and effacement

A

D. cervical dilatation and effacement

48
Q

What composes the cephalic pole?

A. Head
B. Head and upper extremities
C. Head, upper extremities, trunk
D. Head, upper extremities, trunk, lower extremities

A

A. Head

49
Q

A G1P0 came in at 6 am for hypogastric pain. Internal evaluation revealed 5 cm with uterine contractions occurring 2-3 mins at 40-50 s duration, moderate to strong. What time is she expected to deliver?

A. 10-11am
B. 12-1 pm
C. 3-5 pm
D. 5-7 pm

A

B. 12-1 pm

50
Q

What is the primary cause of pain during the second stage of labor?

A. Cervical dilatation
B. Distention of the pelvic floor, vagina, and perineum
C. Uterine contraction
D. All of these are correct

A

C. Uterine contraction

51
Q

A 20-year-old G1 at 41 weeks has been pushing for 3 hours. The fetal head is at the introitus and beginning to crown. It is necessary to cut an episiotomy. The tear extends through the sphincter of the rectum, but the rectal mucosa is intact. How should you classify this type of laceration?

A. First-degree
B. Fourth-degree
C. Third-degree
D. Second-degree

A

C. Third-degree

52
Q

This is where the cardinal fetal movements take place.

A. Dilatational division
B. Pelvic division
C. Phase of maximum slope
D. Preparatory division

A

B. Pelvic division

53
Q

What is the major advantage of a mediolateral episiotomy?

A. Less blood loss
B. Fewer extensions
C. Less post-operative pain
D. Easy surgical repair

A

B. Fewer extensions

54
Q

Which of the statements below best describes active labor?

A. The upper segment contracts and lengthens while the lower segment retracts.
B. The upper segment contracts and thickens while the lower segment lengthens and distends.
C. The upper segment contracts and retracts while the lower segment contracts.
D. The upper segment contracts while the lower segment relax.

A

B. The upper segment contracts and thickens while the lower segment lengthens and distends.

55
Q

Which of the statements below best describes active labor?

A. The upper segment contracts and lengthens while the lower segment retracts.
B. The upper segment contracts and thickens while the lower segment lengthens and distends.
C. The upper segment contracts and retracts while the lower segment contracts.
D. The upper segment contracts while the lower segment relax.

A

B. The upper segment contracts and thickens while the lower segment lengthens and distends.

56
Q

What cardinal movement is essential for the completion of labor where the occiput gradually moves toward the symphysis pubis anteriorly from its original position?

A. Expulsion
B. Internal Rotation
C. Flexion
D. Descent

A

B. Internal Rotation

57
Q

The classic labor mechanisms that involve the cardinal fetal movements take place during:

A. Phase of maximum slope
B. Dilatational division
C. Pelvic division
D. Active phase

A

C. Pelvic division

58
Q

During the preparatory division of labor, which of the following inhibits uterine contractions?

A. Bedrest
B. Warm baths
C. Antibiotics
D. Sedation

A

D. Sedation

59
Q

A 29-year-old woman had a vaginal delivery. A midline episiotomy was done. Which of the following is most likely damage?

A. Puborectalis muscle
B. Levator ani muscle
C. Superficial transverse perineal muscle
D. Pubococcygeus muscle

A

C. Superficial transverse perineal muscle

60
Q

What perineal lacerations are considered Obstetrical Anal Sphincter Injuries?

A. Fourth degree only
B. Third degree only
C. Third and fourth degree
D. Second degree

A

C. Third and fourth degree

61
Q

The pelvic division commences with:

A. Second stage of labor
B. 100 % cervical effacement
C. Full cervical dilatation
D. The deceleration phase of cervical dilatation

A

D. The deceleration phase of cervical dilatation

62
Q

Engagement is the entrance of this diameter of the fetal head in occiput position into the smallest diameter of the maternal pelvis. What diameter of the fetal head is this?

A. Occipitofrontal diameter
B. Suboccipitofrontal diameter
C. Submentobregmatic diameter
D. Biparietal diameter

A

D. Biparietal diameter

63
Q

A vaginal examination should not be performed in which of the following circumstances?

A. G1 at 40 weeks age of gestation with strong contractions occurring every 3-4 minutes
B. G3P1 (1011) on her 18th week age of gestation with watery vaginal discharge
C. G3P2 (2002) at 37 weeks age of gestation with profuse vaginal bleeding
D. G5P4 (2202) on her 34th week age of gestation complaining of painful uterine contractions

A

C. G3P2 (2002) at 37 weeks age of gestation with profuse vaginal bleeding

64
Q

Which of the following is the complication of the third stage of labor associated with forced placental separation?

A. Endometritis
B. Uterine Atony
C. Asherman syndrome
D. Uterine Inversion

A

D. Uterine Inversion

65
Q

What is the maneuver used to facilitate delivery of the fetal head over the perineum in a controlled manner?

A. Ritgen
B. Woods
C. McRoberts
D. Mendelson

A

A. Ritgen

66
Q

What is the OB Score of a patient admitted on her 16 weeks AOG with complaints of vaginal bleeding? She had a pregnancy that was delivered at 28 weeks, stillborn baby girl. One pregnancy delivered at 37 weeks, alive baby boy. Another pregnancy was H. mole which she had suction curettage.

A. G4P2(1111)
B. G3P2(2011)
C. G3P1(1111)
D. G4P2(1122)

A

A. G4P2(1111)

67
Q

A 26-year-old female complains of amenorrhea. If her LMP was last June 13, 2021, when is her EDC?

A. April 20, 2021
B. April 12, 2021
C. March 20, 2022
D. May 21, 2021

A

C. March 20, 2022

68
Q

A G1, 40 weeks AOG has been in labor for 16 hours. IE showed cervix 10 cm, station +3, clear amniotic fluid. Which of the following is correct? She will bear down:

A. At the acme of uterine contraction
B. When the next uterine contraction begins
C. As long as she can
D. For 10 seconds only alternating with rest

A

B. When the next uterine contraction begins

69
Q

After the delivery of the fetal head, suctioning of the nasopharynx is avoided because it may lead to:

A. Low Apgar score
B. Hyperbilirubinemia
C. Neonatal bradycardia
D. Neonatal asphyxia

A

C. Neonatal bradycardia

70
Q

A G1P0 in labor for 14 hours was already fully dilated. Bladder catheterization was done because she was not able to void spontaneously. What is the rationale for this?

A. A distended bladder can cause bladder hypertonia.
B. A distended bladder can cause hypotonic contractions.
C. A distended bladder can hinder descent of fetal head.
D. All of these are correct.

A

C. A distended bladder can hinder descent of fetal head.

71
Q

A G2P1(1000) was in labor, and progress of labor was monitored with the Friedman’s partogram. Which of the following allows stopping the partogram?

A. The amniotic fluid is thickly meconium stained.
B. The cervix is fully dilated.
C. The effacement is 100 %.
D. The fetal heart tone is 100/m.

A

B. The cervix is fully dilated.

72
Q

Uterine relaxation in between contractions is necessary for fetal well-being. What is the duration of the contraction that will compromise uterine blood flow to the fetus?

A. 60 seconds
B. 120 seconds
C. 90 seconds
D. 45 seconds

A

B. 120s

73
Q

Progress of labor is determined in the partogram by assessing:

A. Cervical dilatation
B. Station
C. Uterine contraction
D. Fetal heart tone

A

A. Cervical dilatation

74
Q

A G1P0 at 42 weeks AOG admitted for labor pains with internal exam findings of 4cm dilated cervix, 80% effaced, cephalic, -3, intact membranes. 1 hour after, same IE was noted. Amniotomy was done. What is the least likely reason of doing amniotomy in this patient?

A. Earlier detection of amniotic fluid staining
B. Apply an electrode to the fetus
C. Detect metabolic status of the fetus
D. Hasten labor

A

C. Detect metabolic status of the fetus

75
Q

Which of the following statement regarding delayed cord clamping is true?

A. It increases intraventricular hemorrhage in preterm.
B. A delay of 3 seconds may increase total body iron stores.
C. It increases neonatal umbilical cord pH due to polycythemia.
D. It increases risk for hyperbilirubinemia.

A

D. It increases risk for hyperbilirubinemia.

76
Q

A G1 was in the second stage of labor and FHT was noted to be 100/m. Which of the following is correct in this scenario?

A. Allow labor to progress if the fetal heart tone recovers to normal range before the next expulsive effort.
B. Immediate Cesarean section.
C. Do episiotomy to hasten second stage of labor.
D. Augment labor with oxytocin to hasten delivery.

A

A. Allow labor to progress if the fetal heart tone recovers to normal range before the next expulsive effort.

77
Q

Active management of third stage of labor involves the following except:

A. Nipple stimulation
B. Give uterotonics
C. Delayed cord clamping
D. Controlled cord traction

A

A. Nipple stimulation

78
Q

A G1 on her 40 weeks AOG has been in active labor for 10 hours with strong uterine contractions 50 seconds duration occurring 3/10 min. When is the next IE be done?

A. Not until past 2 hours if no rupture of bag of water
B. When bag of water ruptures
C. After 2 hours or when the bag of water ruptures
D. 20 hrs

A

A. Not until past 2 hours if no rupture of bag of water

79
Q

The first stage of labor is best characterized by which of the following?

A. Uterine preparedness for labor
B. Cervical effacement & dilatation
C. Delivery of the fetus
D. The preparatory phase

A

B. Cervical effacement & dilatation

80
Q

The most important measure of labor progression.

A. Cervical dilatation
B. Contraction duration and intensity
C. Contraction frequency
D. Cervical effacement

A

A. Cervical dilatation

81
Q

What cardinal movement of labor brings the bisacromial diameter into the anteroposterior diameter of the pelvic outlet?

A. Engagement
B. Flexion
C. External Rotation
D. Expulsion

A

C. External Rotation

82
Q

The fetal head is visible at the introitus of a G2P1(1001) who was in labor for 16 hours. What is the fetal station?

A. +5
B. +4
C. +2
D. +3

A

A. +5

83
Q

Coaching during the second stage of labor in a primigravida will:

A. Lessen incidence of perineal tear
B. Shorten second stage of labor
C. Have a better APGAR score of the baby
D. All of these are correct

A

B. Shorten second stage of labor

84
Q

This is the first requisite for birth of the newborn:

A. Flexion
B. Engagement
C. Effacement
D. Descent

A

D. Descent

85
Q

What is the most important force in the expulsion of the fetus?

A. Cervical dilatation
B. Uterine contractions
C. Maternal intra-abdominal pressure
D. Oxytocin concentration

A

C. Maternal intra-abdominal pressure

86
Q

A G4P3(3002) was referred from the local health center due to labor pains. At the ER, uterine contractions were every 3 minutes 50 sec duration and IE revealed cervix already fully dilated and effaced, cephalic presentation, station -1. How many minutes after would you expect this patient to deliver?

A. 50 minutes
B. 20 minutes
C. 60 minutes
D. 15 minutes

A

B. 20 minutes

87
Q

A G1P0 on her 39 weeks AOG was admitted with cervical dilatation of 5 cm at station 0. She was hooked to the fetal monitor. How often should the tracing be evaluated?

A. Every 15 min
B. Every 30 min
C. Every hour
D. Every 5 min

A

B. Every 30 min

88
Q

What phase of parturition comprises the clinical stages of labor?

A. Phase 1
B. Phase 4
C. Phase 2
D. Phase 3

A

D. Phase 3

89
Q

What is the type of placental expulsion wherein the placenta separates first from the periphery?

A. Schultze mechanism
B. Simpson mechanism
C. McRoberts mechanism
D. Duncan mechanism

A

D. Duncan mechanism

90
Q

Fetus in occiput posterior position has an increased risk of:

A. Third degree perineal laceration
B. First degree perineal laceration
C. Second degree perineal laceration
D. None of these are correct.

A

A. Third degree perineal laceration

L3 (1ST BMEX) (18 decks)

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