Abnormal Labour MCQs

Deficiencies of folic acid or vitamin B12 are the most common causes of megaloblastic anemia. If a patient with this type of anemia has a normal serum vitamin B12 concentration, folate deficiency is the most likely cause of the anemia. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 844-45

Ans. D. Half hand method Methods of delivery of aftercoming head are Burns - Marshall method ForcePs delivery Malar flexion and shoulder traction (modified Mauriceau-Smellie-Veit technique)

Infections in pregnancy should be treated, as 25% of patients will develop acute pyelonephritis. Nitrofurantoin, cephalosporins and beta lactams are safe in pregnancy. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 135, Pg: 1077.

Nitrofurantoin, ampicillin, and the cephalosporins are considered relatively safe in early pregnancy. One retrospective case-control study suggesting an association between nitrofurantoin and birth defects has not been confirmed Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 135, Pg: 1077

Asymptomatic bacteruria means the presence of bacteria and WBC in the urine in the absence of symptoms. Microbiological criteria is >10 5 CFU/mL of urine. It requires treatment in: Pregnancy Those undergoing urological procedure Neutropenic patients Renal transplant recepients. The last 2 are relative indications. Reference: Harrison's Principles of internal medicine, 21 st ed, Ch:135, Pg:1075-1077.

Shoulder dystocia Mc Roberts manoeuvre (most commonly performed/first performed manoeuvre) Wood's manoeuvre Zavanelli manoeuvre. Breech extraction Burns Marshall technique (for after coming head of Breech). Modified Mauriceau Smellie-Veit technique (Malar flexion and shoulder traction). Lovset's manoeuvre (for extended arms). Pinard's manoeuvre (for frank breech extraction). Reference: Dutta Obs. 7/e, p 406

In primi's the most common cause of non engagement at term is a deflexed head or occipitoposterior position followed by cephalopelvic disproportion (CPD). Since deflexed head or occipitoposterior is not given in option, we will go for CPD as the answer Also know : Engagement is said to occur when the greatest transverse diameter of the presenting part, has passed through the pelvic inlet. In all cephalic presentations, the greatest transverse diameter is always the biparietal. Engagement occurs in multipara with commencement of labour 38 weeks in the late Ist stage after rupture of membranes and in Nullipara during the last few weeks of pregnancy Reference : Dutta Obs. 7/e, pg 81, 82, 352

Brow Presentation: Engaging diameter – Mentovertical (14 cm). There is no mechanism of labour. Diagnosed on P/V by palpating supraorbital ridges and anterior fontanelle. Delivery is by cesarean section. Reference : Dutta Obs. 7/e, p 392