obgyn

Question 1

What are the indications for forceps delivery?

Answer 1

malpresentation of the fetal head - OT/ OP
prolonged second stage of labour
fetal distress
maternal distress. exhaustion
maternal disease causing risk of prolonged second stage - eclampsia or myasthenia gravis

Question 2

What to do in PPROM

Answer 2

if between 24-31 weeks given steroids
and abx
aim to deliver at 34 weeks

low evidence for tocolytics - only to be given short term to get patient to hospital

is more than 34 weeks gestation then give GBS antibiotics and deliver

Question 3

How do you manage a breech position

Answer 3

Depending on position and gestation the management changes:

patient should be offered ECV at term before ROM unless CI

if preterm - planned C section. C section for preterm babies 22-25 is not recommended

LSCS is preferred method but if mother does not want this can still be delivered via vagina

a classical C section or instrumental delivery is performed if prolonged vaginal birth

do not use ventouse for face or breech

Question 4

absolute indications for classical C section

Answer 4

Lower uterine segment obscured by fibroids
Lower segment covered with dense adhesions
Placenta praevia
Transverse lie with the back down
Foetal abnormality (e.g. conjoined twins)
C-section in the presence of carcinoma of the cervix

Question 5

What do you do straight after delivery of foetus during C section

Answer 5

given 5 IU of syntocin to contract uterus and promote placental separation