Which of the following women is the best candidate for vaginal birth after cesarean (VBAC)?
Client who had a breech presentation in her last pregnancy and this pregnancy is a vertex presentation.
Client who dilated to 6 cm in her last delivery and failed to progress beyond this point after more than 5 hours of labor.
Client who had an emergency cesarean section because of fetal distress with a classical incision.
Diabetic client whose last infant was over 10 lbs., and the provider suspects this infant is larger due to the current ultrasound result.
The Correct Answer is A
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Related Questions
Correct Answer is A
Explanation
Based on the provided information, the probable diagnosis for the spontaneous abortion in this woman would be a threatened abortion, since the cervix is closed and there is no evidence of expulsion of fetal or placental tissue. A threatened abortion is defined as vaginal bleeding occurring before the 20th week of gestation, with a closed cervical os, and no expulsion of fetal or placental tissue.
The other types of spontaneous abortion are defined as follows:
B. Inevitable abortion: vaginal bleeding and cramping with an open cervical os, with or without expulsion of fetal or placental tissue
C. Missed abortion: fetal demise without expulsion of fetal tissue, and may be associated with a closed cervical os and absence of uterine contractions
D. Incomplete abortion: partial expulsion of fetal or placental tissue, with or without vaginal bleeding, and may be associated with an open cervical os and uterine contractions
Correct Answer is D
Explanation
The biophysical profile (BPP) would yield more detailed information about the fetus in this scenario. The BPP is a prenatal ultrasound evaluation that assesses fetal well-being by evaluating five biophysical variables: fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and fetal heart rate. The BPP is a more detailed assessment of fetal well-being compared to a nonstress test and can provide valuable information about the fetus's overall health and well-being, including any potential issues or difficulties.
MSAFP screening is a blood test that can detect certain fetal abnormalities, but it does not provide detailed information about fetal well-being.
Percutaneous umbilical blood sampling (PLBS) is an invasive test that is used to obtain a sample of fetal blood for testing in cases of suspected fetal anemia or other blood disorders. Ultrasound for fetal anomalies is a diagnostic tool used to detect structural abnormalities or defects in the fetus. While it can provide some information about fetal well-being, it is not as comprehensive as the BPP in evaluating fetal health and wellness.
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