During a delivery complicated by shoulder dystocia, the baby’s head retracts back against the perineum after it emerges, a phenomenon known as ‘turtling’. Which of the following is the most appropriate immediate action for the healthcare provider to take?
Wait for the next contraction to try and deliver the shoulders naturally.
Perform the McRoberts maneuver to reposition the mother’s legs and widen the pelvis.
Apply fundal pressure to help push the baby out.
Use vacuum extraction to assist the delivery of the shoulders.
The Correct Answer is B
Choice A rationale
Waiting for the next contraction is inappropriate in shoulder dystocia, where immediate action is required to prevent fetal hypoxia. Delaying intervention can lead to serious complications for the newborn.
Choice B rationale
The McRoberts maneuver, involving hyperflexion of the mother's legs, widens the pelvis, facilitating shoulder delivery in cases of shoulder dystocia. This technique reduces shoulder impaction effectively.
Choice C rationale
Applying fundal pressure is contraindicated in shoulder dystocia as it may worsen the impaction by compressing the fetal shoulders against the maternal pelvis, increasing the risk of injury.
Choice D rationale
Vacuum extraction is not recommended for shoulder dystocia management. This obstetric emergency requires specific maneuvers, like the McRoberts maneuver, to relieve the impacted shoulder.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Multiple gestation increases pregnancy risks but is not directly linked to cervical insufficiency, which involves premature cervical dilation leading to preterm birth or loss without uterine contractions.
Choice B rationale
Advanced maternal age presents various pregnancy risks, including chromosomal abnormalities and hypertension, but is not a primary risk factor for cervical insufficiency, which involves cervical structural issues.
Choice C rationale
A history of preterm labor involves previous early deliveries but does not specifically indicate cervical insufficiency, which is characterized by painless cervical dilation and effacement in the second trimester.
Choice D rationale
Cervical surgery, such as conization or LEEP, can weaken the cervical structure, increasing the risk of cervical insufficiency by reducing the cervix’s ability to remain closed during pregnancy.
Correct Answer is D
Explanation
Choice A rationale
Rh (D) immunoglobulin does not destroy Rh antibodies in newborns; it prevents maternal immune response.
Choice B rationale
Rh (D) immunoglobulin does not damage Rh antibodies in Rh-negative mothers; it prevents antibody formation.
Choice C rationale
Rh (D) immunoglobulin does not stop Rh antibody formation in Rh-positive newborns but prevents it in Rh-negative mothers.
Choice D rationale
Rh (D) immunoglobulin prevents the formation of Rh antibodies in Rh-negative mothers, reducing the risk of hemolytic disease in future pregnancies.
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