An obstetrician is getting ready to perform an emergency lower segmental caesarian section for a 26-year-old woman who is experiencing complications of pre-eclampsia. Once the incision is made through the skin and superficial and deep fascia, what layers will the obstetrician need to traverse/cut through to access the fetus?
A 25-year-old woman visits her GP with complaints of mild abdominal pain and vaginal bleeding. She is currently 6 weeks pregnant and is otherwise feeling well. On examination, she is tender in the right iliac fossa and has a small amount of blood in the vaginal vault with a closed cervical os. There is no cervical excitation. Her vital signs are stable, with a blood pressure of 120/80 mmHg, heart rate of 80 bpm, temperature of 36.5ºC, saturations of 99% on air, and respiratory rate of 14 breaths/minute. A urine dip reveals blood only, and a urinary pregnancy test is positive. What is the most appropriate course of action?
A 35-year-old Gravida 3 Para 3 has given birth to a healthy baby girl. The baby’s APGAR score was 9 at 1 minute and 10 at 5 and 10 minutes.
Regrettably, the mother experienced a perineal tear during delivery. The tear involves the superficial and deep transverse perineal muscles, but the anal sphincter remains intact.
What is the recommended course of action for management?
A 29-year-old woman presents to the clinic with concerns about her pregnancy. She is currently at 30 weeks gestation and reports that her pregnancy has been going smoothly thus far. However, over the past few days, she has noticed a decrease in fetal movement. She denies any recent illnesses or feeling unwell and has no significant medical history. On obstetric abdominal examination, there are no notable findings and the patient appears to be in good health. What is the recommended initial management in this case?
A 28-year-old female patient presents to the clinic at 36 weeks of pregnancy. She reports a decrease in fetal movement over the past few days and is concerned. She has no significant medical history or family history and has had two uncomplicated pregnancies in the past. Physical examination is normal, and vital signs are stable. A handheld Doppler scan reveals no fetal heartbeat.
What is the next course of action in managing this patient?
A 32-year-old woman who is 36 weeks pregnant visits her midwife for a routine check-up. She reports feeling generally well, but mentions experiencing constipation and has been taking lactulose for relief. The midwife conducts the following assessments:
– Fundal height: 37cm
– Blood pressure: 140/90 mmHg
– Urine dip: protein 1+
What would be the best course of action for the midwife to take in managing this patient?
A 28-year-old woman enters the delivery room. Upon examination, the midwife notes that the head has reached the level of the ischial spine. What is the term used to describe the position of the head in relation to the ischial spine?
A 26-year-old female student presents to the Emergency Department with severe abdominal pain that started suddenly while she was shopping 3 hours ago. She reports not having her periods for 8 weeks and being sexually active. She also has a history of pelvic inflammatory disease 4 years ago. On examination, there is generalised guarding and signs of peritonism. An urgent ultrasound scan reveals free fluid in the pouch of Douglas with an empty uterine cavity, and a positive urine βhCG. Basic bloods are sent. Suddenly, her condition deteriorates, and her vital signs are BP 85/50 mmHg, HR 122/min, RR 20/min, and O2 saturation 94%.
What is the most appropriate next step?
You are examining the blood test results of a middle-aged pregnant woman. What result would suggest the requirement for regular antenatal administration of anti-D prophylaxis at 28 weeks?
A 25-year-old female patient visits her GP complaining of severe lower abdominal pain that is not relieved by painkillers. She has no significant medical history. During the evaluation, her GP conducts a pregnancy test, which comes back positive. The patient is immediately referred to the hospital, where a transvaginal ultrasound confirms an ectopic pregnancy in the left tube. What is the best course of action for management?