Abnormal Presentation and Breech

 Abnormal Presentation and Breech:

1. Compound presentation is most consistently associated with :

A. Prematurity.

B. Advanced maternal age.

C. Uncoordinated uterine contractions.

D. Diabetic pregnant woman.

E. Large pelvic vessels.

2. Complete breech means:

A. Flexion at hip joint and extension in knee joint

B. Flexion at hip joint and flexion at knee joint

C. Extension at the hip joint

D. Flexion at knee joint and extension at the hip joint

E. Flexion of one leg at hip joint and extension of the other leg at the hip

joint

3. Regarding shoulder presentation, the following are true EXCEPT:

A. Cord prolapse is common

B. 3rd degree Perineal tear is common

C. Deep transverse arrest can occur*

D. More common in primigravida

E. Always end by shoulder dystocia.

4. Breech presentation: Which is true?

A. Constitutes 10% of all term deliveries

B. Common in post term labor

C. Vacuum extraction can be used when cervix is fully dilated

D. Forceps can be used for after coming head

E. External cephalic version is best performed between 32-34 weeks

gestation.

5. Which of the following is contraindication for delivery using vacuum

extraction?

A. Face presentation

B. Second twins in vertex presentation

C. post term pregnancy

D. Occipito transverse position

E. Chorioamnionitis

6. Umbilical cord prolapse is most likely to occur with:

A. Frank breech.

B. Complete breech.

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C. Single footling breech.

D. Double footling breech.

7. The most frequent severe complication of vaginal breech delivery:

A. Cord prolapse.

B. Spinal cord injury.

C. Head entrapment.

D. Cord avulsion.

E. Placental Separation

8. The major cause of serious neonatal morbidity & mortality for infants with

breech presentation is:

A. Birth trauma.

B. IUGR.

C. Cord prolapse.

D. Associated congenital anomalies.

E. Cerebral palsy.

9. The most common complication of External Cephalic Versions:

A. Placental separation.

B. Fetomaternal hemorrhage.

C. Persistent fetal bradycardia.

D. Inability to convert the fetus to the vertex presentation.

E. Reversion of the fetus to breech presentation.

10. An absolute contraindication for vaginal breech delivery is:

A. Footling breech presentation.

B. Hyperextension of the head.

C. Prolonged latent phase of labor.

D. A large fetus with estimated fetal weight > 3000 gm.

E. Previous pregnancy loss.

11. A 24-year-old G1 P0, Rh-negative , 36 weeks a breech presentation and is

considering external cephalic version. She should be told :

A. She should be offered general anesthesia

B. The procedure can be done with oligohydraminos

C. Prophylaxis with anti-globulin D can wait until after delivery

D. Engagement of the presenting part is not considered a contraindication

to version

E. Tocolysis with intravenous Retodrine has been shown to improve the

results of external version

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12. The following are possible causes of breech presentation EXCEPT :

A. Prematurity

B. Sub-serous fundal fibroid

C. Multiple pregnancy

D. Placenta previa

E. Bicornuate uterus

13. Which of the following is contraindicated for delivery using Vacuum

extraction?

A. Face presentation

B. 38 weeks gestation

C. Chorioamnionitis

D. Post-term pregnancy

E. Occipito transverse position

14. In breech presentation:

A. Frank breech is the commonest type.

B. Brachial plexus injury is a recognized complication.

C. Prolapse of the umbilical cord can occur.

D. Fetal mortality is increased.

E. All of the above.

15. The incidence of breech presentation at term is :

A. 20%

B. 10%

C. 3.5%

D. 15%

E. 0.5%

16. With regard to breech presentation :

A. In vaginal delivery the fetus is prone to Cephalohematoma

B. Hyperextension of the fetal head is a favorable

C. External cephalic version (ECV), reduces the breech presentation at term

1%

D. Mid trimester amniocentesis is likely to result in breech presentation at

term

E. The perinatal morbidity is ten time higher than in cephalic presentation

17. External cephalic version is contraindicated in all of these conditions EXCEPT

A. Scarred uterus

B. Multiple pregnancy

C. Placenta previa

D. Severe maternal hypertension

E. Gestational diabetes

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18. Regarding Breech presentation, the following are true EXCEPT:

A. Accounts for up to 3 % term pregnancies

B. May be diagnosed on clinical examination of the abdomen

C. May be associated with fetal abnormality

D. Is a contraindication for vaginal delivery

E. Makes intrapartum hypoxia more likely than is true of cephalic

presentation

19. An infant presents as a breech presentation and delivered without assistance

as far as the umbilicus. The reminder of the body is manually assisted by the

obstetrician. This is called :

A. Version and extraction

B. Spontaneous breech delivery

C. Assisted breech delivery

D. Total breech extraction

E. Pipers of the after-coming head

20. At 39 week gestation, a fetus was felt to be breech presentation as judged by

information gained through Leopold's maneuvers. The breech was well down

in the pelvis, and the uterus was irritable. Pelvimetry was within normal limits

and the estimated fetal weight was 3.4 kg. which of the following should be

done ?

A. Cesarean section

B. External cephalic version

C. Internal podalic version

D. Oxytocin induction

E. None of the above

21. All are causes of breech EXCEPT:

A. Prematurity.

B. Congenital anomalies.

C. Hydrocephalus.

D. Pelvic tumor.

E. Increased maternal age.

22. All of the following associated with increase incidence of breech presentation,

EXCEPT:

A. Placenta previa

B. Müllerian anomaly

C. Uterine leiomyoma

D. Nulliparity

E. Prematurity

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23. The following are contraindication to external cephalic version, EXCEPT:

A. Contracted pelvis

B. Placenta previa

C. Multiple pregnancy

D. Presence of cervical suture in site

E. Scared uterus

24. Face presentation :

A. All cases must be delivered by C-section.

B. All cases can be delivered vaginally.

C. The presenting diameter is occipitofrontal.

D. The fetal head is hyperflexed.

E. Mentoposterior position must be delivered by C-section.