A woman is in labour with her first child. The midwife becomes concerned that the cardiotocograph is showing late decelerations. She is reviewed by the obstetrician on-call who states that there is fetal compromise, but no immediate risk to life. A category two caesarean section is planned.
What is the timeframe for the delivery to be performed?
A 35-year-old woman who is 32 weeks pregnant with twins comes to you complaining of intense pruritus that has been affecting her sleep for the past 4 days. She has multiple excoriations but no visible skin rash. The pregnancy has been uneventful, and foetal movements are normal.
Her blood tests show:
– Bilirubin 38 µmol/L (3 – 17)
– ALP 205 u/L (30 – 100)
– ALT 180 u/L (3 – 40)
An abdominal ultrasound shows no abnormalities.
What is the most likely diagnosis, and what management plan would you recommend?
A 28-year-old G3P2 woman at 32 weeks gestation presents to the emergency department with sudden and severe lower abdominal pain that started 45 minutes ago. She reports a small amount of vaginal bleeding but her baby is still active, although movements are slightly reduced. She has had regular antenatal care and her medical history is unremarkable, except for a 10 pack-year smoking history. Her two previous children were born vaginally and are healthy at ages 4 and 6.
The patient is alert and oriented but in significant pain. Her vital signs are within normal limits except for a blood pressure of 150/95 mmHg and a heart rate of 120 beats per minute. A cardiotocograph shows a normal baseline fetal heart rate with appropriate accelerations and no decelerations.
What is the most likely diagnosis and what is the next appropriate step in management?
A 25-year-old woman is experiencing labour with a suspected case of shoulder dystocia and failure of progression. What is the Wood’s screw manoeuvre and how can it be used to deliver the baby?
A 35-year-old woman gives birth to twins through vaginal delivery after induction. She experiences a blood loss of 800ml and continues to bleed, but her haemodynamic status remains stable. What should be the next course of action in managing this patient?
A 29-year-old woman who is 10 weeks pregnant presents to the early pregnancy assessment unit with vaginal bleeding and abdominal pain that started yesterday. She has a history of Von Willebrand disease. A trans-vaginal ultrasound scan confirms a missed miscarriage. The patient is currently stable without fever or hemodynamic instability. What is the most suitable initial approach to manage this patient’s miscarriage?
A 32-year-old primigravida woman is 41 weeks pregnant and has been offered a vaginal examination and membrane sweeping at her antenatal visit. Despite these efforts, she has not gone into labor after 6 hours. Upon examination, her cervix is firm, 1 cm dilated, 1.5 cm in length, and in the middle position. The fetal head station is -3, but there have been no complications during the pregnancy. What should be the next appropriate step?
A 25-year-old primigravida woman at 36 weeks gestation comes in with mild irregular labor pains in the lower abdomen. Upon examination, her cervix is firm, posterior, and closed, and fetal heart tones are present. However, the pain subsides during the consultation. What would be the most suitable course of action?
A woman in her late twenties at 28 weeks gestation, complains of painless bright red vaginal bleeding. She mentions experiencing two previous instances of slight painless vaginal bleeding, but believes that this episode is much more severe. What is the probable diagnosis?
A 32-year-old woman who is 13 weeks pregnant had pre-eclampsia in her previous pregnancy and underwent a caesarean section at 36 weeks gestation. Her blood pressure has been normal since then and today. What intervention should be suggested to decrease the likelihood of pre-eclampsia recurrence?