QUESTION 39

 A 32-year-old woman, gravida 2 para 1, at 28 weeks gestation comes to the office for a prenatal visit The patient has had no

contractions, vaginal bleeding, or leakage of fluid. Fetal movement has been normal. This pregnancy has been uncomplicated, but

her last pregnancy ended with a low transverse cesarean delivery due to an abnormal fetal heart rate tracing. The patient has no

chronic medical conditions and takes a daily prenatal vitamin. Vital signs are normal. Fetal heart rate is 145/min and fundal height is

24 cm. An ultrasound is performed due to a discrepancy between fundal height and gestational age, and shows a posterior placenta;

a normal amniotic fluid volume; a fetus in transverse lie with shoulder presentation; and estimated fetal weight consistent with

gestational age The patient is concerned about the fetal presentation; she asks if the baby will stay in this presentation and if she can

have a vaginal delivery Which of the following is the most appropriate response to this patient?

Q A "A vaginal delivery is not recommended because of the fetal presentation and placental location. "

Q B. "A vaginal delivery is not recommended because of the fetal presentation and type of prior cesarean delivery. "

Q C. "A vaginal delivery is possible, and the baby will likely turn to the correct presentation on its own. "

Q D. "A vaginal delivery is possible, but we will likely need to turn the baby during labor."

Q E. "A vaginal delivery is possible if we turn the baby to the correct presentation at this visit"