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  #1  
Old 08-07-2013
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ObGyn OB/GYN question #1

These questions are short and concise, Ob/GYN is not that hard if you know the basics.. So I wont put long ass cases because I dont have a source to do that and because i dont think it is necessary to do so.

A 34 y/o female G3 P2 presents to the L&D (Labor and delivery) unit at 38 weeks gestation. She is 1 cm dilated and 30% effaced. When you perform your PE with Leopold maneuvers you notice the fetus lie is transverse with the back facing the mother pelvis. You quickly order a bedside ultrasound which confirms the diagnosis of transverse lie. Which of the following is the best step in the management of this patient?
A. Observation.
B. External rotation.
C. Internal Rotation.
D. C-Section.
E. Use of forceps to change the fetal position
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  #2  
Old 08-07-2013
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Ans B , child has the tendency to correct its position till 37 weeks after that do external rotation
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Old 08-07-2013
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Quote:
Originally Posted by XpaezX View Post
These questions are short and concise, Ob/GYN is not that hard if you know the basics.. So I wont put long ass cases because I dont have a source to do that and because i dont think it is necessary to do so.

A 34 y/o female G3 P2 presents to the L&D (Labor and delivery) unit at 38 weeks gestation. She is 1 cm dilated and 30% effaced. When you perform your PE with Leopold maneuvers you notice the fetus lie is transverse with the back facing the mother pelvis. You quickly order a bedside ultrasound which confirms the diagnosis of transverse lie. Which of the following is the best step in the management of this patient?
A. Observation.
B. External rotation.
C. Internal Rotation.
D. C-Section.
E. Use of forceps to change the fetal position
yep child was suppose to fix him self lol....External Rotation for now....C section is too invasive. Forceps are not used for this
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Old 08-07-2013
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Default Wont give the answer yet.. but

PLease read here.

External cephalic rotation is indicated ONLY on this presentation
READ THIS

after reading that re-think your answer
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Old 08-07-2013
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Originally Posted by XpaezX View Post
PLease read here.

External cephalic rotation is indicated ONLY on this presentation
READ THIS

after reading that re-think your answer
Thats fine but i always thought Ext Cephalic Version was perfromed after 37 weeks. But she is in labor already. Unless you can still try this procedure than i guess thats the answer
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Old 08-07-2013
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yeah you are right.
i guess its C section .
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Old 08-07-2013
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Originally Posted by Kais_MD View Post
Thats fine but i always thought Ext Cephalic Version was perfromed after 37 weeks. But she is in labor already. Unless you can still try this procedure than i guess thats the answer
Yes you are correct, thats why I put another question where EXTERNAL CEPHALIC VERSION is indicated and it is done.

On this particular question the fetus is not on breech but he is TRANSVERSE.. here you dont do that but go directly to C-section.. why? because there was a study that showed less morbidity when doing C-section because transverse fetus have the highest risk of cord prolapse, even more than breech babies. And remember that external cephalic version carries a high risk of umbilical cord prolapse for the fetus.
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Old 08-07-2013
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Originally Posted by XpaezX View Post
Yes you are correct, thats why I put another question where EXTERNAL CEPHALIC VERSION is indicated and it is done.

On this particular question the fetus is not on breech but he is TRANSVERSE.. here you dont do that but go directly to C-section.. why? because there was a study that showed less morbidity when doing C-section because transverse fetus have the highest risk of cord prolapse, even more than breech babies. And remember that external cephalic version carries a high risk of umbilical cord prolapse for the fetus.
I need to do kaplan vids for ob/gyn in the next two weeks again....whats funny is that it was my strongest subject so i didnt pay much attention to it lol. THanks buddy keep them coming
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  #9  
Old 08-07-2013
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Correct Answer

Quote:
Originally Posted by Kais_MD View Post
I need to do kaplan vids for ob/gyn in the next two weeks again....whats funny is that it was my strongest subject so i didnt pay much attention to it lol. THanks buddy keep them coming
Thats the goal of these questions and thats why im helping you, you are still on time to review and learn some new stuff before your exam, glad you saw weaknesses so these can be corrected ASAP!
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