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Operative Vaginal Delivery

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Accepted maternal indications for operative vaginal delivery include all EXCEPT which of the following?

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a. Mitral stenosis

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b. Spinal cord injury

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c. Pelvic floor protection

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d. Second-stage labor lasting > 2 hr in a multipara with epidural analgesia

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Accepted fetal indications for forceps delivery include which of the following?

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a. Nonreassuring fetal heart rate pattern

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b. Prevention of intracranial hemorrhage from maternal pushing in the fragile preterm fetal head

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c. Prevention of intracranial hemorrhage from maternal pushing in the fetus with known coagulopathy

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d. All of the above

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Which of the following is true of high forceps delivery?

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a. Indicated for fetal distress

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b. No role in modern obstetrics

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c. Forceps applied when the fetal head is engaged

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d. Indicated for those with prolonged second-stage labor

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All EXCEPT which of the following criteria must be met prior to operative vaginal delivery?

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a. Membranes ruptured

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b. Cervix completely dilated

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c. Regional anesthesia placed

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d. Fetal head position determined

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In all EXCEPT which of the following settings would forceps delivery be preferred to vacuum extraction?

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a. Maternal Marfan disease

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b. Delivery of a 33-week gestation

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c. Mentum anterior face presentation

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d. Rotation of the fetal head from occiput transverse to occiput anterior position

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You are called to see your multigravid patient for prolonged fetal bradycardia. She is now 10 cm dilated, and membranes are ruptured. The head is at +2 station and shows poor descent with pushing. The fetal head is positioned left occiput posterior and is resistant to an attempt of manual rotation to ...

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