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Operative Vaginal Delivery

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

a. Mitral stenosis

b. Spinal cord injury

c. Pelvic floor protection

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

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

a. Nonreassuring fetal heart rate pattern

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

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

d. All of the above

Which of the following is true of high forceps delivery?

a. Indicated for fetal distress

b. No role in modern obstetrics

c. Forceps applied when the fetal head is engaged

d. Indicated for those with prolonged second-stage labor

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

a. Membranes ruptured

b. Cervix completely dilated

c. Regional anesthesia placed

d. Fetal head position determined

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

a. Maternal Marfan disease

b. Delivery of a 33-week gestation

c. Mentum anterior face presentation

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

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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