Which of the following are contraindications for VBAC? (Select All that Apply.).
A prior vaginal delivery.
Gestation of 42 weeks.
Maternal obesity.
One prior cesarean delivery.
Macrosomic fetus.
Correct Answer : C,E
Choice A reason:
A prior vaginal delivery is not a contraindication for VBAC. In fact, it is a positive predictor of success for VBAC, as it indicates that the woman has a proven pelvis and can tolerate labor.
Choice B reason:
The gestation of 42 weeks is not a contraindication for VBAC. However, it is associated with an increased risk of stillbirth while awaiting spontaneous labor, which should be balanced against the risks of induction of labor or elective repeat cesarean.
Choice C reason:
Maternal obesity is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of maternal and neonatal complications. The decision to attempt VBAC in obese women should be made on a case-by-case basis by a senior obstetrician.
Choice D reason:
One prior cesarean delivery is not a contraindication for VBAC. Most women who have had one prior lower segment cesarean delivery are eligible for VBAC, as the risk of uterine rupture is low (0.5%) and the success rate is high (72-75%).
Choice E reason:
A macrosomic fetus is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of shoulder dystocia and birth trauma. The decision to attempt VBAC in women with suspected macrosomia should be made on a case-by-case basis by a senior obstetrician.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
FAS is caused by alcohol, and NAS is caused by opioids. This is the correct answer because FAS stands for fetal alcohol syndrome, which is a condition that affects the development of a baby when the mother drinks alcohol during pregnancy. NAS stands for neonatal abstinence syndrome, which is a group of problems that can happen when a baby is exposed to opioid drugs for a length of time while in their mother's womb.
Choice B reason:
FAS and NAS are both incurable. This is incorrect because FAS and NAS are not diseases, but conditions that result from prenatal exposure to substances. FAS and NAS can cause various physical, mental, and behavioral problems in the baby, some of which may be permanent, but others may be improved with early intervention and treatment.
Choice C reason:
FAS is caused by analgesics and NAS is caused by NSAIDs. This is incorrect because analgesics are painkillers, and NSAIDs are nonsteroidal anti-inflammatory drugs. Neither of these types of drugs is known to cause FAS or NAS. However, some analgesics, such as codeine and oxycodone, are opioids and can cause NAS if used by pregnant women.
Choice D reason:
FAS and NAS are both curable. This is incorrect because FAS and NAS are not diseases, but conditions that result from prenatal exposure to substances. FAS and NAS can cause various physical, mental, and behavioral problems in the baby, some of which may be permanent, but others may be improved with early intervention and treatment. However, there is no cure for FAS or NAS.
Correct Answer is C
Explanation
Choice A reason:
Intermittent abdominal pain following passage of bloody mucus is not a sign of placenta previa, but rather of bloody show, which is a normal occurrence in late pregnancy as the cervix begins to dilate and efface.
Choice B reason:
Abdominal pain with minimal red vaginal bleeding is not a sign of placenta previa, but rather of abruptio placentae, which is a serious complication where the placenta detaches from the uterine wall before delivery.
Choice C reason:
A large amount of bright red vaginal bleeding without pain is a sign of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. This can cause bleeding when the cervix dilates or contracts, especially in the third trimester. This is a medical emergency that requires immediate attention.
Choice D reason:
Severe abdominal pain with increasing fundal height is not a sign of placenta previa, but rather of uterine rupture, which is a rare but life-threatening complication where the uterus tears open along the scar line from a previous cesarean delivery or other uterine surgery. This can cause severe bleeding, fetal distress, and shock.
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