[New 2020] Rotational Births and Vacuum-Assisted Birth Quiz
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Questions and Answers

What is one of the essential conditions for safe assisted vaginal birth?

  • Avoidance of preparation and planning
  • Clear communication with healthcare personnel (correct)
  • Lack of clinical assessment
  • Regular use of abdominal ultrasound

    • What evidence level supports the reliability of ultrasound assessment for fetal head position prior to assisted vaginal birth?

  • Evidence level 2
  • Evidence level 3
  • Evidence level 4 (correct)
  • Evidence level 1

    • According to RCOG Green-top Guideline No. 26, what is the recommendation regarding the routine use of abdominal or perineal ultrasound for assessing the fetal head during the second stage of labor?

  • Not recommended (correct)
  • Partially recommended
  • Mandated
  • Highly recommended

    • In what situation may a low forceps be acceptable for assisted vaginal birth?

    <p>With suspected fetal bleeding disorders</p> Signup and view all the answers

    What is a key aspect of safe assisted vaginal birth in terms of expertise?

    <p>Expertise in the chosen procedure</p> Signup and view all the answers

    What should clinicians be aware of regarding ultrasound assessment prior to assisted vaginal birth?

    <p>'Gold standard' status of ultrasound assessment</p> Signup and view all the answers

    Why should vacuum extraction be avoided in assisted vaginal birth?

    <p>Avoidance is not necessary</p> Signup and view all the answers

    Who should perform assisted vaginal birth?

    <p>Operators with the necessary knowledge, skills, and experience</p> Signup and view all the answers

    What training is recommended for obstetric trainees before performing assisted vaginal birth?

    <p>Competency in spontaneous vaginal birth</p> Signup and view all the answers

    Why is training in vacuum and forceps birth important for obstetric trainees?

    <p>To receive appropriate training for assisted vaginal birth</p> Signup and view all the answers

    What is a key contributor to adverse outcomes in assisted vaginal birth?

    <p>Inadequate training of healthcare providers</p> Signup and view all the answers

    When should complex assisted vaginal births be performed?

    <p>Only by experienced operators or under their direct supervision</p> Signup and view all the answers

    What is the goal of assisted vaginal birth?

    <p>To mimic spontaneous vaginal birth with minimal morbidity</p> Signup and view all the answers

    Why is it important for operators to manage any complications during assisted vaginal birth?

    <p>To prevent adverse outcomes and ensure patient safety</p> Signup and view all the answers

    What did the meta-analysis of nine studies comparing PCEA to continuous infusion show about obstetric outcomes?

    <p>They were comparable</p> Signup and view all the answers

    In the RCT comparing PCEA with continuous epidural infusion, what was reported about the rates of normal birth?

    <p>Similar between PCEA and continuous infusion</p> Signup and view all the answers

    What did the systematic review find regarding assisted vaginal birth when oxytocin was used at 6 cm dilatation onwards?

    <p>No impact on assisted vaginal birth rates</p> Signup and view all the answers

    According to the NICE intrapartum care guideline, what is the recommendation about starting oxytocin in the second stage of labor for multiparous women?

    <p>It should not be started routinely</p> Signup and view all the answers

    What did the meta-analysis report about the rates of uterine rupture in multiparous women where oxytocin had been commenced?

    <p>Higher rates of uterine rupture</p> Signup and view all the answers

    In what stage of labor should oxytocin be used with caution according to the NICE intrapartum care guideline?

    <p>Second stage</p> Signup and view all the answers

    What is recommended before considering oxytocin in the second stage of labor for a multiparous woman?

    <p>An assessment by an experienced obstetrician</p> Signup and view all the answers

    What is a major risk associated with Caesarean birth in the second stage of labour compared to completed assisted vaginal birth?

    <p>Major obstetric haemorrhage</p> Signup and view all the answers

    What is a potential consequence of using two instruments sequentially during delivery?

    <p>Higher risk of neonatal trauma</p> Signup and view all the answers

    In a population-based retrospective analysis in the US, what was the reported risk associated with sequential use of vacuum and forceps compared to forceps alone?

    <p>Increased risk of needing mechanical ventilation</p> Signup and view all the answers

    What is the risk of intracranial hemorrhage for births involving two instruments during delivery?

    <p>$1$ in $256$</p> Signup and view all the answers

    What risk does Caesarean birth in the second stage of labour pose to the baby?

    <p>Increased admission to the neonatal unit</p> Signup and view all the answers

    How does the risk of neonatal trauma compare between the use of two instruments and failed forceps proceeding to Caesarean birth?

    <p>Higher risk with two instruments</p> Signup and view all the answers

    What is a potential consequence of a prolonged hospital stay related to Caesarean birth in the second stage of labour?

    <p>$1$ in $500$ risk of major obstetric hemorrhage</p> Signup and view all the answers

    What does a population-based retrospective analysis report about the use of vacuum and forceps compared to forceps alone?

    <p>$2.22$ times increased risk of needing mechanical ventilation</p> Signup and view all the answers

    What is a potential consequence of applying sequential instruments during delivery?

    <p>$2.5$ times increased need for mechanical ventilation</p> Signup and view all the answers

    When should vacuum-assisted birth be discontinued?

    <p>Whenever there is no evidence of progressive descent with moderate traction during each pull.</p> Signup and view all the answers

    What should experienced operators do if there is minimal descent with the first two pulls of a vacuum?

    <p>Evaluate the fetal position and cephalopelvic disproportion.</p> Signup and view all the answers

    Which option is recommended for completing vacuum-assisted birth in the majority of cases?

    <p>Maximum of three pulls to bring the fetal head onto the perineum.</p> Signup and view all the answers

    In what circumstances should less experienced operators stop a vacuum-assisted birth?

    <p>If there is minimal descent with the first two pulls of a vacuum.</p> Signup and view all the answers

    What is the maximum number of pulls recommended for easing the head out of the perineum during vacuum-assisted birth?

    <p>Three additional gentle pulls.</p> Signup and view all the answers

    Why is it important for experienced operators to stop and seek a second opinion during vacuum-assisted birth?

    <p>To check if they should change their approach or discontinue the procedure.</p> Signup and view all the answers

    Which action indicates that vacuum-assisted birth should be discontinued?

    <p>'Pop-off' occurring after two pulls.</p> Signup and view all the answers

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