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Part 2 book “Get through – DRCOG: SBAs, EMQs and MCQs” has contents: Management of labour and delivery – answers, postpartum problems (the Puerperium), including neonatal problems, gynaecological problems, fertility control. | 8 MANAGEMENT OF LABOUR AND DELIVERY – ANSWERS SBAs Answer 1: C The second stage of labour begins with full dilatation of the cervix and ends with the delivery of the baby. A delayed second stage is when the active second stage lasts ≥2 hours in nulliparous and ≥1 hour in multiparous women. Intermittent auscultation for fetal heart should happen at least every 5 minutes for at least a minute after a contraction. Routine use of oxytocin is not recommended in the second stage of labour. Further reading NICE clinical guideline 55. Intrapartum care. 2007. Available at: guidance.nice.org .uk/CG55 Answer 2: C The success rate of a planned VBAC after one previous uncomplicated caesarean birth is 72–76%. The risk of uterine rupture is 50 per 10,000 VBAC and this risk increases two to three times higher if the labour is induced or augmented. VBAC should be conducted in a suitably staffed and equipped delivery suite, with continuous intrapartum monitoring and care with available resources for immediate caesarean section and neonatal resuscitation. Further reading RCOG Green-top guideline No. 45. Birth after previous caesarean birth. 2007. Available at: www.rcog.org.uk/womens-health/clinical-guidance /birth-after-previous-caesarean-birth-green-top-45 Answer 3: C The recommended method of fetal monitoring in low-risk labouring women is intermittent auscultation of fetal heart and, in high-risk women, cardiotocography 127 Chapter 8 Management of Labour and Delivery – Answers should be used. The normal baseline fetal heart rate is 110–160 bpm and the absence of accelerations in an otherwise normal CTG is of uncertain significance. FBS is indicated when the CTG is pathological and normal fetal pH is ≥7.25. Further reading Collins S, Arulkumaran S, et al. Oxford Handbook of Obstetrics & Gynaecology. 3rd ed. Oxford: Oxford University Press; 2013. Answer 4: D Fetal presentation has no effect on perception of fetal movements. Further reading RCOG Green-top guideline. .
