U2 Ob - Et 32 Obstetric Procedures: Vbac
- 1.When should discussions about VBAC begin with a patient who has had a prior Cesarean delivery?
- A.
Preconception
- B.
At an early prenatal visit
- C.
In the third trimester
- D.
Two weeks before delivery
- E.
Upon admission to the hospital in active labor
- 2.Which of the following are contraindications to VBAC? (There may be more than one answer.)
- A.
Previous vaginal delivery
- B.
Adequate pelvis
- C.
Prior classical uterine incision
- D.
Multiple uterine surgeries
- E.
Contraindications to vaginal birth
- F.
A, B, and C
- G.
B, C, E
- H.
C, D, E
- 3.Which of the following are requirements of the facility at which a patient will deliver to offering a VBAC?
- A.
In house obstetrician
- B.
1:1 nurse to patient ratio
- C.
Obstetrician skilled in emergency Cesarean delivery in house
- D.
Anesthesiologist within 30 minutes drive time to hospital
- E.
Internal fetal monitoring
- 4.A 25 year-old G3P2002 presents to the hospital in active labor. She planned on attempting a trial of labor. Assuming a spontaneous vaginal delivery, which of the following risks of a Cesarean delivery will this patient have lowered most significantly?
- A.
Uterine rupture
- B.
Death
- C.
Uterine inversion
- D.
Hemorrhage
- E.
Cervical laceration
- 5.A 32 year-old G2P1 had a prior Cesarean delivery due to a breech presentation of the fetus. She is attempting a trial of labor in a major metropolitan university hospital. She is currently 6 cm dilated, 100% effaced and the fetus is at 0 station. She is also having contractions every 3 – 4 minutes according to external monitoring. The fetal heart tracing has shown numerous accelerations and no decelerations since her admission. The monitor suddenly starts to show prolonged fetal bradycardia that does not resolve with a change in maternal position or the administration of oxygen to the patient. Which of the following has most likely occurred?
- A.
Uterine rupture
- B.
Intrauterine infection
- C.
Cord prolapse
- D.
Pulmonary embolism
- E.
Impending intrauterine fetal demise
- 6.Which of the following should not be used in a patient attempting a VBAC?
- A.
Pitocin
- B.
Continuous lumbar epidural anesthesia
- C.
IV morophine
- D.
Pencillin
- E.
Misoprostol
- 7.Which of the following decreases the chances of having a successful VBAC?
- A.
Recurrent indication for initial Cesarean delivery
- B.
Gestational age greater than 40 weeks
- C.
Induction of labor
- D.
Maternal obesity
- E.
All of the above
- 8.A 22 year-old G5P2113 with a history of HIV wants to discuss VBAC as an option since she has had two prior spontaneous vaginal deliveries and her last son was delivered via Cesarean delivery due to breech presentation. Which of the following patient factors increases her chances of a successful VBAC?
- A.
Prior spontaneous vaginal delivery
- B.
Multiparity
- C.
HIV status
- D.
Young maternal age
- E.
Short interpregnancy interval
- 9.True or False: Suspected macrosomia should not preclude a trial of labor for a patient who has undergone a prior Cesarean delivery.
- A.
True
- B.
False
- 10.True or False: Most maternal morbidity that occurs during a trial of labor occurs when repeat Cesarean delivery become necessary.
- A.
True
- B.
False
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