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A 26-year-old primigravid woman at 38 weeks' gestation is admitted to the hospital because she is in labor; contractions occur every 3 minutes and last 60 seconds. The patient's prenatal course has been uncomplicated. Labor curve is now normal and fetal heart rate tracing shows good variability with an occasional mild deceleration. Her patient chart indicates that a previous physician thought she might have a platypellic pelvis. She is now 10-cm dilated. The fetus is at +1 station with a mentum-anterior face presentation. Which of the following is the most appropriate management at this time? A) Deliver the child vaginally after manually rotating the fetus to a mentum-posterior presentation B) Deliver the child vaginally with the aid of forceps C) Deliver the child vaginally with the aid of vacuum extraction [D) Deliver the child vaginally without intervention] E) Deliver the child via emergency cesarean delivery ....
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D..
As long as there is maternal or fetal compromise is not evident, labor with a face presentation may continue.
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mdinmd r u sure because i saw some sources online encurage CS .....but iam not sure !!!
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sure they NBME questions ....but mdinmd do you think this article work for platypelloid pelvis , i also read that only 3% of female with this type of pelvis need CS....thanx
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yes, that is why I'm not sure either. But if u look at the way question is worded "Her patient chart indicates that a previous physician thought she might have a platypellic pelvis". That sentence seems to be a red herring. If she had a serious pelvic abnormality she would have been advised to have C-section much earlier and not allowed to go into labour.
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wissam, I'm not familiar with NBME is it a website or question book. Thanks.
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mdinmd leave ur email and i ll send you what i have ...NBME national board medical exam they have question that you can can buy it on line it is very similar to the exam ....
